Children Summer Camp June

Please complete both forms below for the Children Summer Camp 2025

June 1-5, 2025 - Age 9-14

Children Summer Camp 2025 Application Form - June

Children Summer Camp 2025 Photo Release Form - June

Children Summer Camp 2025 Application Form - June 1-5, 2025 (Age 9-14)

Step 1 of 16

Please complete all fields and for items not pertaining to your child you may write N/A

Camper Information

Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Age (at the time of the camp)(Required)

Gender(Required)

Male

Female

Grade in School (2023-2024)(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian Information

Parent/Guardian Name(s)(Required)

First Last

Name

First Last

Phone Number(s)(Required)

Phone Number(s)

Email Address(es)(Required)

Emergency Contact Information

Please provide contact information for someone other than the child’s parent/guardian in case of emergency.

Emergency Contact Name(Required)

First Last

Relationship to Camper(Required)

Phone Number (s)(Required)

Phone Number (s)

Medical Information

Primary Care Physician Name(Required)

First Last

Physician Phone Number(Required)

Health Insurance Provider(Required)

Policy Number(Required)

Medical Conditions/History

(Please list any medical conditions, recent surgeries, or any other relevant health information we should be aware of)

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Medications

Please list any medications your child takes regularly. Include dosage instructions and the reason for the medication.

Medication 1

Dosage/Instructions:

Reason for Medication

Medication 2

Dosage/Instructions:

Reason for Medication

If more medications apply, please list them below:

Allergies

Please list any allergies (food, medication, environmental, etc.) that the camper has.

Allergy 1

Reaction/Severity:

Allergy 2

Reaction/Severity:

Behavioral/Emotional Considerations

Please note any special considerations or behaviors that our staff should be aware of to ensure your child's safety and comfort:

Permission and Acknowledgments

Emergency Medical Treatment: In case of an emergency, I give permission for camp staff to seek medical treatment for my child if necessary(Required)

Yes

Photo/Video Release: I give permission for my child to be photographed or videotaped during camp activities for church promotional purposes.(Required)

Yes

Camp Rules Acknowledgment(Required)

I acknowledge that my child will follow the camp rules and guidelines, and I understand that failure to do so may result in my child being sent home early at my expense.

Camper's Emergency Health Information

Does your child have any chronic health conditions (e.g., asthma, diabetes, epilepsy, etc.)?(Required)

Yes

If yes, please describe:

Does your child require any special accommodations or have any specific needs?(Required)

Yes

If yes, please describe:

Has your child had a tetanus shot in the past 5 years?(Required)

Yes

If no, please explain:

Transportation Information

Will your child be dropped off at the camp or do they require transportation?(Required)

Dropped off by parent/guardian

Require transportation (Please specify pick-up and drop-off location)

Please specify pick-up and drop-off location

Who will be picking up your child at the end of the camp?

Name(Required)

First Last

Relationship to Camper:(Required)

Packing List

Please ensure that your child comes prepared with the following items (Check boxes to confirm each item):

Sleeping bag or bedding

Comfortable clothing for 4 days

Swimsuit & towel

Comfortable shoes/sneakers

Hat, sunscreen, and sunglasses

Water bottle

Bible or devotional materials

Medications (if applicable)

Toiletries (toothbrush, toothpaste, soap, etc.)

Flashlight

Personal items (e.g., journal, pen)

Any additional items (please specify):

Specify additional items:

Health and Safety Guidelines

To ensure the safety and well-being of all campers, please be aware of the following: 1. Health Protocols: ○ In case of illness, campers will be evaluated by the camp medical staff. Parents will be notified immediately if any child requires medical attention. ○ Campers should not attend if they have had a fever or contagious illness in the last 24 hours before the start of camp. 2. Camp Behavior Expectations: ○ Respect for fellow campers and staff is essential. Any disruptive behavior may result in a meeting with parents and, if necessary, early dismissal from the camp. 3. Food and Snacks: ○ We will provide meals for all campers. If your child has any dietary restrictions or preferences, please specify them under "Allergies" or "Dietary Needs." ○ Please note: Snacks will be provided at certain times. If your child has specific snack preferences or restrictions, let us know. 4. Camp Communication: ○ Parents may contact the camp staff during camp hours for emergencies or inquiries. Contact details will be provided prior to camp. ○ We will also have regular communication and updates via [phone, email, or app] during the camp.

Additional Permission Forms and Notices

Over-the-Counter Medications Permission:(Required)

Yes

I give permission for camp staff to administer common over-the-counter medications (e.g., Tylenol, Advil, Benadryl) in case of need.

Permission for Supervision:(Required)

Yes

I give permission for my child to be supervised by camp counselors during activities, including outdoor, recreational, and team-building exercises.

Permission for Supervision:(Required)

Yes

I give permission for my child to be supervised by camp counselors during activities, including outdoor, recreational, and team-building exercises.

Parent/Guardian Acknowledgment and Signature

By signing below, I confirm that all information provided is accurate to the best of my knowledge. I understand that the church and camp staff will take all necessary precautions to ensure the safety and well-being of my child. I also understand that the camp reserves the right to send my child home if they fail to comply with the camp’s rules and policies.

Parent/Guardian Name(Required)

First Last

Signature(Required)

Date(Required)

MM slash DD slash YYYY

Thank you for taking the time to complete the form. We are excited to have your child join us for an unforgettable summer experience!

Payment

Summer Camp Registration Fee - June 2025(Required)

Price:

Credit Card

Total

Children Summer Camp 2025 Photo Release Form - June 1-5, 2025 (Age 9-14)

Step 1 of 3

33%

Camper's Name(Required)

First Last

Parent/Guardian's Name(Required)

First Last

Phone(Required)

Email(Required)

Child's Name(Required)

Consent Statement

I, the undersigned, hereby grant RCCG the Americas permission to use photographs and/or videos of my child,

taken during camp activities. I understand that these images may be used for promotional materials, camp websites, social media, and other non-commercial purposes. I acknowledge that no compensation will be given for the use of these images and that they may be used indefinitely unless otherwise requested in writing. I also understand that my child’s full name will not be disclosed in any public materials.

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I AGREE to allow my child’s photo/video to be used.

I DO NOT AGREE to allow my child’s photo/video to be used.

Signature

Parent/Guardian Signature:(Required)

Date(Required)

MM slash DD slash YYYY

If you have any concerns or wish to revoke consent at any time, please contact [email protected] Thank you for your cooperation!

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Leadership

Children Summer Camp June

Please complete both forms below for the Children Summer Camp 2025

June 1-5, 2025 - Age 9-14

Children Summer Camp 2025 Application Form - June 1-5, 2025 (Age 9-14)

Camper Information

Parent/Guardian Information

Emergency Contact Information

Medical Information

Medical Conditions/History

Medications

Allergies

Behavioral/Emotional Considerations

Permission and Acknowledgments

Camper's Emergency Health Information

Transportation Information

Packing List

Health and Safety Guidelines

Additional Permission Forms and Notices

Parent/Guardian Acknowledgment and Signature

Payment

Children Summer Camp 2025 Photo Release Form - June 1-5, 2025 (Age 9-14)

Consent Statement

Signature

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