Building Construction Camp Registration Form

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DATE & TIME: June 19 - 22 from 6:30pm - 8:30pm

LOCATION: Treasuring Christ Church, 3101 Rock Quarry Road, Raleigh, NC 27610

DINNER WILL BE PROVIDED EACH NIGHT.

COST: FREE

Activity: Students who have completed 6th - 11th grades are invited to participate in a building construction camp where they will learn and utilize basic woodworking skills in order to complete a project they they will take home at the end of the week. Teenagers will use basic tools and power tools (such as a miter saw, circular saw, table saw, and drill) to complete the project.

FOR MORE INFORMATION PLEASE CALL 919-800-9439.

Email *

Participant's Name *

Birthdate: *

YYYY

Age *

Male or Female *

Female

Male

Name of Parent/Guardian *

Address *

Phone Number *

What is the name of emergency contact (other than the parent)? *

What is the relationship to the camper? *

What is their phone number? *

Please list all allergies and/or medical conditions of the participant. *

Is Treasuring Christ Church authorized to approve medical treatment? *

Yes

Is participant covered by personal/family medical insurance? *

Yes

If yes, what is the name of insurer and policy or group number (optional)?

I acknowledge that participation in the activity described above involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above (the “activity”), the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the “activity sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association. *

I agree

I disagree

I give Treasuring Christ Church permission to take pictures and and video my children as they participate in this camp. Treasuring Christ Church may use images of me and my children on their website and corresponding social media accounts including but not limited to Facebook, Instagram, and Twitter to promote the church and the programs they offer. I acknowledge and agree that I will receive no payment for the use of these images on any digital or print advertising.

Yes

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Name of parent/guardian filling out this registration form *

Send me a copy of my responses.

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