Family Camp Registration for Children attending Nursery through 6th Grade Services

Family Camp provides childcare and worship services for those nursery age through 6th grade. To help us plan for each of our services, we'd like to have you pre-register your child(ren). 
 
 
This Number Can Receive Text Messages *

Child information

Please fill out information for all children in your household who will be attending the nursery through 6th grade at family camp or assembly. 
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Emergency contacts

Relationship to child *
 
Additional Emergency Contact's Relationship to Child *
 

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
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Consent to Treat

I hereby give consent for the camp nurse to dispense over the counter medication, suchas, but not limited to, Acetaminophen, Ibuprofen, etc. to the camper named above. I alsohereby authorized the release of all medical information to an attending physician in caseof an emergency. In the event that I cannot be reached immediately, I hereby give permission to the camp staff to secure proper emergency medical care for illness orinjury incurred during camp for camper named above.

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Medical/Liability 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.
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