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Elijah Camp Registration 2019

REGISTRATION COSTS

-- DAY CAMP --

April 1 - May 1: $115

May 2 - June 1: $130

-- OVERNIGHT CAMP --

April 1 - May 1: $180

May 2 - June 1: $200

** Please note: 8 Year Olds may choose to attend either Day Camp or Overnight Camp for the week.

Day Camp is currently open for only 6-8 year olds only.

Overnight Camp is currently open for 8-12 year olds only.

Total Number of Children
Pre-Registration Information

If you have already pre-registered & check this box, the $25 per child that you have paid will be taken off your total registration cost in the amount you pay on this form

If you did not complete pre-registration, leave blank
Day or Night Information

PARENT INFORMATION SECTION

EMERGENCY CONTACT INFORMATION

CHILD INFORMATION SECTION

Either a parent or legal guardian may register a child.

All children must be at least 6 years old by June 11th in order to attend camp.

Child 1

Child 2

If not applicable write N/A or leave blank

Child 3

If not applicable write N/A or leave blank

Child 4

If not applicable write N/A or leave blank

DROP OFF / PICK UP INFORMATION

--Day Camp--

Drop Off At New Bridge Church: Monday - Thursday @12PM

Pick Up At New Bridge Church: Monday - Thursday @6:30PM

--Overnight Camp--

Drop Off at Campground: Monday @ 10AM

Pick Up at Campground: Friday @12PM

HEALTH INSURANCE AND LIABILITY INFORMATION

LIABILITY AND MEDICAL WAIVER

Activity/Media Permission

The parent or legal guardian applicant of this form gives permission for the child/children applicant of this form to participate in all camp activities at, to and from campuses from June 10th through June 14th 2019, unless otherwise stated. I give full permission for my child/children to be photographed and video and to have his/her/their photos, films, and/ or sound recordings used in publicity in any media. I assume full responsibility for the risk and/or occurrence of personal injury, death, and/or property damage due to the negligence and/or fault of the parties released by this document, and/or due to the condition of the premises on or in transit to which the activities will take place, whether such negligence, fault, and/or condition of the premises is present at the signing of this agreement or takes place in the future. I release IHOP Atlanta, New Bridge Church, any affiliated organizations, staff or volunteers from all claims, demands, actions, rights of action, or other legal rights to claim compensation for any loss, injury or illness, which I or my child/children/legal trustee may sustain as a result of their participation in the camp. Further, I agree to indemnify and hold all parties released by this document harmless from any such claims or demands. I understand every effort will be made to contact me or the emergency contact persons listed above. In the event that we cannot be reached, I hereby give permission to the physician listed on the form to hospitalize, secure proper treatment for my child(ren).

Medical Permission

Furthermore, I give my permission to the IHOP Atlanta & New Bridge Camp Directors to act in my place as a parent/guardian in cases where consent is required in emergency situations and to provide medical treatment as may be required due to any injury/illness my child/legal trustee may sustain during camp. I do release, acquit, discharge and covenant to hold harmless IHOP Atlanta & New Bridge Church, its staff, volunteers and all attending health care professionals from all actions, damages or liabilities arising out of the treatment of any illness, injury, or accident incurred during my child’s/children's participation in this event. It is the intention of this release that IHOP Atlanta & New Bridge Church, its staff, volunteers and all attending health care professionals incur no liability whatsoever while attempting to meet all medical needs that my child/legal trustee may require during this event. Elijah Camp and all overhead organizations are not responsible for costs incurred for medical care.

Regulations

I give permission for sunscreen to be administered and / or applied to my camper as deemed necessary by camp staff. I agree that any camp participant's belongings may be searched outside of the participant's presence for drugs, alcohol, weapons, or other prohibited objects. Campers are asked to leave any valuable electronics at home. Elijah Camp and its staff and volunteers are not responsible for lost or stolen items. I agree to cooperate with all regulations, and understand registration fees are not refundable, especially if my child chooses to leave or is asked to leave because of disciplinary issues and lack of cooperation or compliance.

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