Trinity Kids Summer Camp Final Registration

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Parent/Guardian Phone Number

Family Address

When selecting your child's age, be sure to select the age your child will be the first day of camp (July 22, 2024).

If the class for that age is full, you can join the waitlist. You are not required to pay a deposit to be on the waitlist, so please select the "Waitlist" option under Deposit Payment field. There are options to join the waitlist for one child and register another at the same time. You will only pay a deposit for the child with a spot available.

Additionally, there are scholarship opportunities available. Please select the "I'd like to be considered for a scholarship" option in the Deposit Payment field when completing the form. Someone will follow up with you directly about scholarship options.

Child #1

Child #1 Name

Date of Birth

Gender

Male Female

Age

Special Needs/Allergies:

Will your student need to bring and medications and/or medical devices (inhaler, EpiPen) with them? If so, please list your student's medications and/or medical devices here.

I hereby authorize Holy Trinity Anglican Church to take photographs, or any other media representation, of my child(ren) while participating in Trinity Kids for use in print, on-line, or video-based materials for the purposes of promoting the church and its programs. I release HTC, its staff, and volunteers from any and all responsibility/liability that may arise as a result of the creation and use of such photos or media representations.

Child #2

Child #2 Name

Date of Birth

Gender Male Female

Age

Special Needs/Allergies:

Will your student need to bring and medications and/or medical devices (inhaler, EpiPen) with them? If so, please list your student's medications and/or medical devices here.

Photo permission for social media/newsletters

Child #3

Child #3 Name

Date of Birth

Gender Male Female

Age

Special Needs/Allergies:

Will your student need to bring and medications and/or medical devices (inhaler, EpiPen) with them? If so, please list your student's medications and/or medical devices here.

Photo permission for social media/newsletters

Child #4

Child #4 Name

Date of Birth

Gender Male Female

Age

Special Needs/Allergies

Will your student need to bring and medications and/or medical devices (inhaler, EpiPen) with them? If so, please list your student's medications and/or medical devices here.

Photo permission for social media/newsletters

Emergency Contacts

Emergency Contact #1 Name

Phone

Relationship to Child(ren)

If other, please list relationship to the child(ren).

Birthdate

Emergency Contact #2 Name

Phone

Relationship to Child(ren)

If other, please list relationship to the child(ren).

Birthdate

Authorized Adults for Pick Up

List all adults who are authorized to pick up your child from Summer Camp. Please include grandparents, neighbors, sitters, etc. The person picking up your child (including parents) will be required to show their ID so that our team of volunteers can validate that you have authorized them to pick up your child. We will not release children to adults who are not on this list. If you have a change of plans, you can add someone later.

AUTHORIZATION TO CONSENT TO TREATMENT OF MINOR

I/We, the undersigned parent(s) or lawful guardian(s) of minor(s) listed above, authorize Holy Trinity Anglican Church to serve as my/our agent for determining the need of, and for authorizing, any diagnosis, treatment, and medical care (including, but not limited to determining the type of health care professional and hospital care needed) determined by Holy Trinity Anglican Church to be advisable during the trip named above. I/We understand this authorization is given in advance of any specific diagnosis, treatment or medical care being required, and is given to provide authority and power on the part of Holy Trinity Anglican Church to give specific consent to any and all such diagnosis, treatment or medical care that the health care professional in the exercise of his or her best judgment may deem advisable. LEGAL RELEASE In consideration of Holy Trinity Anglican Church determining the need for, and type of, diagnosis, treatment, or medical care (if any), I/We release Holy Trinity Anglican Church from any and all liability whatsoever for bodily injuries, property damage, or other claims sustained during or related to the diagnosis, treatment, and medical care. I/We also agree to indemnify Holy Trinity Anglican Church and/or its agents for, and hold Holy Trinity Anglican Church and/or its agents harmless from, any and all claims or suits brought by any person or entity to the extent of any and all costs, expenses, damages, judgments, verdicts, and/or attorneys’ fees. LIABILITY FOR VANDALISM OR DAMAGES I/We agree that aforesaid minor will be held personally responsible for any vandalism, and for damages caused by negligent behavior or failure to follow camp rules.

Agree Disagree

Be a part of the team

Anything we should know?

Is there anything you want us to know about your child that will help us make your child feel more comfortable while in our care?

Preschool Camp Information

Is your child potty-trained? yes no working on it

I would like to receive the Trinity Kid's newsletter. Yes No

I would like to receive the church newsletter. Yes No

Final Payment

If your children have pre-registered, your remaining balance should be $75 for one child and $125 for two children.

If you are registering your children for the first time, the cost to register is: $150 for one child and $100 for each additional child.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Trinity Kids Summer Camp Final Registration - The Great Jungle Journey

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Trinity Kids Summer Camp Final Registration - The Great Jungle Journey

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