Foothills Youth Camp 2023 ages 10-18

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

Home Church Name *

Name (First, Last) *

Gender *

Male

Female

Age *

Rising School Grade *

Parent(s) Name *

Address *

Home Church Address *

Emergency Contact Name and Phone Number *

Please list restricted activities and reason if any

Allergies *

Yes

If yes, please list all allergies

Medications *

Yes

Required

If medications needed, please list including dosage directions

T-Shirt Size *

XXL

XXXL

Insurance Information: List name of company and policy holder's name. *

I HEREBY GIVE PERMISSION TO THE CAMP STAFF OF FOOTHILLS FELLOWSHIP INC. AND WOODLAND BAPTIST CHURCH TO OBTAIN EMERGENCY MEDICAL TREATMENT FOR MY CHILD, AS NAMED ON THIS APPLICATION. I CERTIFY THAT MY CHILD IS IN GOOD PHYSICAL CONDITION, AND IS ABLE TO PARTICIPATE IN THE ENTIRE CAMPING PROGRAM OTHER THAN ACTIVITIES LISTED AS RESTRICTED. I UNDERSTAND I WILL BE CONTACTED IMMEDIATELY IF TREATMENT BY A PHYSICIAN IS REQUIRED. I RELEASE FOOTHILLS FELLOWSHIP INC. AND WOODLAND BAPTIST CHURCH FROM ALL LIABILITY AND INJURY. *

Yes, I accept

No, I do not accept

Please read all packing list and rules for camp *

No, I do not accept

Yes, I do accept

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms