NCO's Family Camp Amazing NazaRace Registration

The Amazing NazaRace is for participants of all ages. This is designed for young, old, and in-between to have an opportunity to have some fun together, while competing at physical, mental, and silly challenges. Some obstacles will include physical activity and others are all about using your mind.

Teams will be created to ensure intergenerational. So sign up your whole family, as a couple or an individual. Everyone will be placed on a team.

Your Name (First & Last) *

Age: years *

Phone number *

This Number Can Receive Text Messages *

Yes

No

Email *

Do you have any medical conditions we need to be aware of during the race? If so, please explain. *

Name of Church Affiliation (ex. Mount Vernon First Church of the Nazarene) *

Register Additional Household Members

Please only register additional members of your household as team members.

Depending on the number of individuals registered, additional team members may be added to groups. So your team may not only be your household.

Do You Have Additional Team Members to Register? *

First Team Member's Name *

Age: years *

Does this team member have any medical conditions we need to be aware of during the race? If so, please explain. *

Second Team Member's Name

Age: years

Does this team member have any medical conditions we need to be aware of during the race? If so, please explain.

Third Team Member's Name

Age: years

Does this team member have any medical conditions we need to be aware of during the race? If so, please explain.

Fourth Team Member's Name

Age: years

Does this team member have any medical conditions we need to be aware of during the race? If so, please explain.

Fifth Team Member's Name

Age: years

Does this team member have any medical conditions we need to be aware of during the race? If so, please explain.

Emergency contacts

Emergency Contact Name *

Emergency Contact Phone Number *

Relationship to Team Member *

Parent

Neighbor

Friend

Family member (please indicate relationship) Family member (please indicate relationship)

Additional Emergency Contact Name *

Additional Emergency Contact Phone Number *

Relationship to Team Member *

Parent

Neighbor

Friend

Family member (please indicate relationship) Family member (please indicate relationship)

Media Release

Media Release
I hereby grant permission to the rights of my image, likeness and sound of my voice asrecorded on audio or video tape without payment or any other consideration. I understandthat my image may be edited, copied, exhibited, published or distributed and waive theright to inspect or approve the finished product wherein my likeness appears.

Photographic, audio or video recordings may be used for the following purposes:
• conference presentations
• educational presentations or courses
• informational presentations
• promotional videos

*

I Grant Permission

I Do Not Agree Grant Permission

Medical Release

With my signature, I hereby validate this application form and do expressly waive any and all claims against the NCO District Church of the Nazarene and/or any of its Boards and/or any of its representatives, because of illness, injury, or damage to the person or property of the above names applicant in condition with, or incident to, the NCO Family Camp Amazing Race.

Your Signature *

clear

Today's Date * +