FIX!

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

FIX!

February 29th - March 1st 2020
Please fill out the form in its entirety to sign up for the 2020 FIX! Retreat at Lakeview Christian Camp.

* Required

First Name *

Last Name *

Grade *

Male/Female *

Male

Female

Church *

Home Address *

City *

State *

Zip *

Phone Number *

Email *

Emergency Contact *

Emergency Contact Phone Number *

Work Number *

Relationship to Camper *

I hereby give permission to Lakeview Christian Camp to use any photographs, accounts, or videos of myself or child taken by staff or volunteers to be used for related camp activities, programs, and/or promotion, including printed material and on internet and social media sites, by Lakeview Christian Camp and/or its sponsoring churches. (SIGN/TYPE NAME) * *

I release Lakeview Christian Camp staff, faculty, volunteers, officers, and sponsoring churches from all liability. I agree to indemnify, defend, and hold harmless Lakeview Christian Camp, staff, faculty, volunteers, officers, and sponsoring churches for any injuries or damages incurred while participating in the camp program and/or on camp property.(SIGN/TYPE NAME)

In case of an emergency, Lakeview Christian Camp will make every effort to contact those people listed on the registration form. In the event that the camp is unable to contact me, I give my permission for the camp to secure treatment for my child.(SIGN/TYPE NAME) *

I understand that I will have to pay $50 either by paypal or cash/check before or upon arrival *

Yes

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Lakeview Christian Camp. Report Abuse

Forms