2024 Music Camp and/or Sports Camp Walnut Creek UMC Registration Form 
Event Timing: June 17th-21st, 2024, option to do either half-day camp or choose full day option.
Ages: 1st grade (rising) through 6th grade (rising), older children may register as helpers with permission of the directors.

Sports Director is trained through the ASYO training program, and is a CYO Certified Coach for Basketball. The Music Director is trained as an educator and professional musician. For more information contact office@walnutcreekumc.org. 

Sports Camp: 9AM-12noon: (early drop-off available from 8AM-9AM-) at East Bay Formosan UMC outside field (1755 Sunnyvale Ave, Walnut Creek, CA 94597). Please bring a water bottle. If you are able, please bring your own ball (soccer ball size 4/basketball size 7). Please wear shin guards and close-toed sports shoes. 

Bring-Your-Own Lunch for full day campers: 12noon- 1PM: at Walnut Creek UMC (1543 Sunnyvale Ave, Walnut Creek, CA 94597) Full Day Campers will walk together from East Bay Formosan UMC to Walnut Creek UMC with their packed lunches. Campers will be supervised during the lunch hour.

Music Camp: 1PM-5PM: (late pick-up available from 5PM-5:30PM) at Walnut Creek UMC (1543 Sunnyvale Ave, Walnut Creek, CA 94597). Campers will rotate through sessions of music, art, and drama. There will be a sharing of the things we learned during worship on Sunday, June 23, 10:00AM.

Registration (donation) fee: one child = $30 (half-day, choose sports camp or music camp) or $50 (all day) per week.  

Send Check to WCUMC to 1543 Sunnyvale Avenue, Walnut Creek, 94597 or bring cash/check payment the first day of Camp or click here for electronic payment. Please note on check memo line - Summer Camp 2023.

Please submit a registration for each child. Bring Driver's License/ ID for check in and check out. If you would like to also volunteer as an adult, a background check and Safe Gathering Training will be required. Please contact Walnut Creek UMC for more information. 

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Email *
First and Last Name of Minor Camper (or Youth volunteer) *
Birthdate of Camper *
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Gender
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Email *
Home Address (address or addresses)  *
Emergency Contact and permission to pick up #1,
Enter Full Name and Cell Phone
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Emergency Contact and permission to pick up #2,
Enter Full Name and Cell Phone
What grade will your camper enter in the Fall? *
Which camp(s) your child will attend (check all that apply) *
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What is your child's t-shirts size? *
If registering for Sports Camp, please check the boxes that apply to your camper
Dietary restrictions (Note: for snacks only; please pack lunches for whole day campers). Click all that apply. *
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I understand that I will have to pay upon arrival, if not pre-paid. *
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Any special needs or other considerations?
Release of Liability (Please Read and type your name below) ATHLETIC WAIVER OF LIABLITY And MUSIC CAMP WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT There are certain inherent risks associated with participating in sports and/or athletic training/ arts camp that cannot be eliminated. These risks include, but are certainly not limited to: (1) minor injuries such as scratches, cuts, bruises and strains; and (2) major injuries such as injuries to the eyes, infection, loss of sight, joint injuries, back injuries, heart attacks, concussions, paralysis and even death. Also included in these risks are the same or similar injuries that might result from using training equipment, actual use of a field or training facilities, the acts of others or from the unavailability of emergency staff or emergency medical care (hereinafter we shall define all of these risks and potential injuries as “Risks”). All of these Risks will be present in the activities that you and/or your minor will be participating in at East Bay Formosan UMC and Walnut Creek UMC ). HAVING READ THIS PARAGRAPH and having an appreciation for and an UNDERSTANDING OF THESE RISKS, you hereby affirm that you and/or your minor’s participation in these Activities is voluntary and that you agree on behalf or yourself or your minor to all of the following:

 1. ASSUMPTION OF RISK I, on behalf of myself and/or my minor, ASSUME ALL OF THE RISKS THAT MAY OR CAN ARISE OUT OF PARTICIPATING IN THE ACTIVITIES, INCLUDING BUT NOT LIMITED TO THE ATHLETIC ACTIVITY ITSELF, USE OF THE EQUIPMENT, FIELD OR FACILITIES, THE ACTS OF OTHERS OR THE UNAVAILABLITY OF EMERGENCY CARE, as well as those Risks described in the preceding paragraph.

 2. INDEMNITY/HOLD HARMLESS I, on behalf of myself and/or my minor and/or our heirs, personal representatives and/or assigns, also agree to indemnify and hold harmless East Bay Formosan UMC/ Walnut Creek UMC , as well as their affiliates, parents, subsidiaries, assigns, partners, attorneys, members, employees, independent contractors, shareholders, officers, directors, and agents or any producers, investors, cast members or any other person or entity associated in any way with the ownership, operation or affiliation with recreational facilities and the creation, production or distribution of East Bay Formosan UMC/ Walnut Creek UMC marketing content on any East Bay Formosan UMC/ Walnut Creek UMC , from any and all claims, causes of actions, lawsuits, arbitrations or proceedings as well as from any expenses, judgments, costs, fees, damages, expenses and/or liabilities, including attorneys’ fees incurred in defending or prosecuting any such claims brought against East Bay Formosan UMC/ Walnut Creek UMC   as the result of my or my minor’s participation in the Activities.

3. RELEASE/WAIVER In consideration for being permitted to participate in the Activities, I, on behalf of myself and/or my minor and/or our heirs, personal representatives and assigns HEREBY RELEASE, WAIVE AND DISCHARGE East Bay Formosan UMC/ Walnut Creek UMC  from any and all liability associated with or related to my or my minor’s participation in the Activities and agree NOT TO SUE East Bay Formosan UMC/ Walnut Creek UMC for any reason resulting from or associated with my or my minor’s participation in the Activities. This waiver and release is intended to include all claims for injuries, accidents, illnesses, or property loss, whether known or unknown or anticipated or unanticipated, which are in any way related to or associated with the Activities. 

4. NO INSURANCE I, on behalf of myself and/or my minor, acknowledge that East Bay Formosan UMC/ Walnut Creek UMC does not carry insurance on behalf of myself or my minor. 

5. LEGAL RIGHTS I, on behalf or myself and/or my minor, understand and acknowledge that I/we are surrendering valuable legal rights in this agreement.

6. SEVERABILITY I, on behalf or myself and/or my minor, understand and expressly agree that this agreement is intended to be as broad and inclusive as permitted by the law of the State for which it is used and that if any portion of this agreement is held invalid, it is agreed that the balance of the agreement shall continue in full force and effect and that whatever portion is held invalid shall be interpreted and construed to afford as much protection to East Bay Formosan UMC/ Walnut Creek UMC  as permitted by the applicable law.  OF MINORITY AGE - (UNDER AGE 18 AT THE TIME OF REGISTRATION) CONSENT AND RELEASE ON BEHALF OF MINOR I am the parent and/or legal guardian of the above named minor participant. I have read this agreement thoroughly and understand all of the terms. I understand that I am surrendering legal rights on behalf of the minor and myself. I, on behalf of myself and my minor, agree to be bound by all of the terms of this agreement and also give my consent to allow my minor to participate in the Activities described herein. I release and agree to indemnify and hold harmless the Releasees from any kind and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, even if arising from the negligence of the releases, to the fullest extent permitted by law. 

If you agree, please enter the camper's name and the parent/guardian's typed in signature and date in the blanks below:
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East Bay Formosan UMC/ Walnut Creek UMC would like to use participants' images or likeness without current or future compensation for marketing purposes related to East Bay Formosan UMC/ Walnut Creek UMC. 
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Insurance and Doctor information (Please include insurance information and Primary Care's number)
I give permission for medical care to be offered if I cannot be reached in case of an incident/injury of my camper. *
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Any other questions you may have?
A copy of your responses will be emailed to the address you provided.
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