The Ram Foundation's Participant Application
Thank you for your interest in the free summer enrichment program with The Ram Foundation. We are truly grateful that God has granted us the opportunity to provide this valuable service to the Pine Hurst, Eau Claire, and surrounding communities. We are looking forward to a fun and productive 6 weeks of instruction, the fine arts, and recreation. The starting date is Monday, June 14, 2021 with our ending date on Saturday, July 24, 2021. The camp will run from 8:00 AM to 12 noon – Monday through Friday. This year, we will only have one location: Greater Faith Baptist Church (119 Crawford, Columbia, SC 29203).

If you have more than one child attending, please fill out a separate application for each child. Applications are to be received no later than May 31, 2021.

All participants must be at least 4 years old. If you are enrolling a child who is under the age of 6 years old, you MUST provide a copy of the child’s birth certificate.

There is a one-time registration fee of $25.00 per child.

For questions, please email deitra241@gmail.com or call/text 803-479-3373.

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电子邮件地址 *
Participant's Last Name *
Participant's First Name *
Participant's Age *
Participant's Last Grade Completed *
Parent/Guardian's Full Name *
Participant's Street Address *
City *
Day Phone Number *
Evening Phone Number *
Doctor *
Doctor's Address *
Allergies *
Medication *
Notes/Special Considerations *
Name of Insurance *
Address of Insurance *
Phone Number of Insurance *
Policy Number of Insurance *
I certify that my child is in good physical health and is physically able to participate in recreational activities. I understand that in the event of illness or injury, I do hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of attending physician, surgeon, or dentist and performed by or under the supervision of a member or medical staff of the hospital or facility furnishing medical or dental services.  In addition, I have been advised to obtain personal medical coverage. Although I give permission to the Reading, Arts, Mathematics Summer Enrichment Program to administer routine non-surgical care (e.g. First Aid) to my child, I understand that such care is limited and that I will have full medical coverage for my child’s participation only if I obtain such coverage on my own. Furthermore, I agree to use my personal medical insurance as a primary medical coverage payment if accident or injury occurs. *
必填
Other Individual Authorized to Pick Up Your Child *
How did you hear about us? *
In consideration of my child’s participation in the activities, I hereby waive all claims of causes of action against The Ram Foundation and Greater Faith Missionary Baptist Church, the employees, and each and every officer, agent, and employee affiliated with the summer enrichment program arising out of my child’s participation in the activity and hereby release, hold harmless, and discharge The Ram Foundation from all liability in connection therewith. Knowing, understanding, and fully appreciating all possible risks, I hereby expressly, voluntarily, and willingly assume all risks and dangers associated with my child’s participation in ALL activities. *
必填
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