CAMP 2019 Registration
* Date of Birth - Child must be 6-12
* Does your child have any pertinent emotional, mental or behavior concerns or limitations?
* Does your child have any severe, life-threatening allergies?
* Is your child bringing any medication with him or her? Please provide details:
- Child's medical information
* Health Card #
* Doctors Phone Number
Waiver & Medical Release
- I, the undersigned, hereby release Fellowship Pickering and any persons, staff, or volunteers associated with Fellowship Pickering, from any and all liability in connection with the aforementioned event. I understand that it is my responsibility to disclose any special concerns or considerations about my child on this form. Fellowship Pickering has my permission to use necessary medical measures in the event of an emergency, I will be contacted. If I cannot be reached, the emergency contact indicated above will be notified as soon as possible. I also give Fellowship Pickering permission to have, use, and reproduce photographs or videotapes of my child taken during this event for its own record or public relations/promotions efforts.
* Digital Signature - I HAVE read the WAIVER & MEDICAL RELEASE - Please type your name below
All registrations are non refundable
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