Name
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First Name
Last Name
Email
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Phone
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(###)
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T-Shirt Size
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S
M
L
XL
XXL
Volunteer Availability
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I wish to volunteer in the following classes
Please select 3 only
Responsibilities
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Please check at least 3
Please explain any medical restrictions here:
Electronic Consent to Medical Emergency Terms/Conditions
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In case of medical emergency, I understand that every reasonable attempt will be made to contact me or the emergency contact named above. However, in the event that I or my named contacts cannot be reached, I give my permission to the adults in charge of the programs to secure and receive emergency medical or first aid treatment for my child, including transport via ambulance to a hospital if necessary. I consent to the sharing and release of any medical information listed above with the appropriate staff members of the program and/or medical personnel that may be necessary to ensure the safety and wellbeing of my child. I agree to pay for any charges for emergency medical treatment that are not covered by my personal health insurance.
Release and Waiver
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I, the undersigned, hereby acknowledge that certain risks of injury are inherent to any camp’s program, including but not limited to participation in recreational activities, a child’s failure to follow instructions of supervisors, communicable illness, and independent acts of third parties not under the control of supervisors. I acknowledge that all risks cannot be prevented, and assume those beyond the control of the staff. These types of injuries may be minor or serious and may result from one’s actions, or the actions or inactions of others or a combination of both. I will take responsibility to see that I am prepared for all activities and am in good health each day of the session.
I hereby assume all risks associated with participation in Charis Character Camp (CCC) and agree to hold harmless CCC, the Church of the Servant (the Church), its directors, officers, employees, volunteers, et al, from and against any and all claims, damages, demands, action or right of action, losses or liability of any kind or nature which may arise in connection with injuries suffered to me while enrolled/participating in their program. I have read and understand the above informed consent agreement in its entirety and hereby give my consent to participate knowing all of the foregoing.
Consent to Photo/Video Release
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I understand that CCC may produce promotional material relating to its activities. As a participant at CCC, I may be included in videotapes or photographs taken during the camp. I grant to CCC the right to photograph and/or videotape me and to utilize such videotapes and photographs, my name, face likeness, voice and appearance as part of the camp.
Consent to Rules and Expectations
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I understand that I must reflect a good example for students regarding the rules above and understand that students must abide by the rules and behaviors expected to ensure everyone’s safety and enjoyment of CCC. Failure to comply with these rules may result in the child’s removal from CCC. I will act responsibly upon any injuries the child sustains, any inappropriate behavior, or in any incidents of sexual misconduct, harassment or assault.
Consent to Background Check
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Please note that we require a background check for all consenting adults (18+). Information on how to submit necessary information will be sent following the completion of this form. Thank you!
