BaseCamp2026/27

* First Name

* Last Name

* Birth Date

* Grade (Grade entering in the Fall)

* Gender

* Allergy/child notes

* Name of Parent/Guardian

* Mobile Phone

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* Email

* Address

* City

* State/Province

* Zip/Postal Code

* Emergency Contact Name

Medical Release

Medical and Liability Release Form: We realize that no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are to be aware of your responsibility to instruct your child of the importance of conduct which will insure safety and enjoyable time while participating in this activity. By signing this form, you, as a parent, guardian or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injuries to the child for whom you sign. I give my child permission to participate in Fairview Kids or Fairview Students activities, and give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.

Photo Release

Photo Release: I further give my permission for the use of any photo or likeness of my child to be used by Fairview Missionary Church for their use in promotional materials.

* Digital Signature-I HAVE read the release statement listed above and agree to it