Waterski Camp Registration

A Ministry of True Life Church

2021 Registration Form

UPDATE ON CAMP REGISTRATIONS
We only have 6 spots left for the guys as of April 30 | The girls is full and a waiting list is set up.

Things to remember: Total camp Fee is $310 per camper (3 or more same family $275 per camper)
A $100 Non-refundable deposit is required per camper with your registration to secure the spot.
Space is limited.
Payments may be made via E-Transfer to finance@bellaliant.com (Please put camper name and amount paid in the message box of the E-transfer.
We have limited capacity – Total 48 students (24 Girls/24 Guys.) This is a first come basis and we do require the deposit to guarantee your spot.

Waterski Camp Registration 2021

Date of Registration (D/M/Y) *

I am Registering my *

Son
Daughter

Camper Name *

First

Last

Full Mailing Address *

Parent/Guardian Name *

First

Last

Home Phone *

Alternate Phone *

Parent/Guardian Email *

Birthdate: (D/M/Y) *

Grade in Fall 2021 *

Church Attended *

If you don not have a home church just put NONE

Emergency Contact Information

Emergency Contact Name *

Relationship to Student *

Emergency Contact Number *

T Shirt Size *

Adult Small
Adult Medium
Adult Large
Adult X-Large

Please Note: We cannot confirm sizes after June 30

Roommate(s) Request *

Boatmate(s) Request *

Medical Information

Medicare Number *

Family Physician *

Date of Last Tetanus Shot - Year *

Please put Year

Please list any Medications (prescription or otherwise) the camper will bring with them to camp *

Put NONE if the camper will not be bringing any medications to camp

Please list any and all medications that can be administered to the camper by the camp nurse. Gravol Benadryl Dristan Ibuprofen Tylenol Claritin Reactin Rub A535 Polysporin Hydrogen Peroxide/Disinfectant Spray *

Does the camper presently, or at times in the past, struggle with any of the following? Please list Heart Issues Ear Aches Skin Irritations Hernias Indigestion ADD/ADHD Hay Fever Asthma Diabetes Seizures Heat Stroke Sleepwalking Concussion Nausea/Vomiting Other *

If this does not apply, please put NONE

Please disclose any physical, emothional, mental, social, or behavioral concerns or limitations of which we should be aware *

If this does not apply, please put NONE

Permissions (please read carefully and check the box)

I consent to my son/daughter’s picture being used in future promotional materials for Waterski Camp. I understand that no personal details will be disclosed for any reason

Permissions (please read carefully and check the box)

I understand that boating, water sports, and other camp activities have inherent risks beyond the contemplation and control of camp staff. Precautions are taken for the health and safety of your child, but in the event of accidental death, injury or illness, True Life Church, its staff and volunteers are hereby released from any and all liability. I give the leadership of this camp the authority to make medical decisions in my absence on my child’s behalf. In the event that any camper requires special medication, x-rays or treatment, parents/guardians will be notified immediately. In case of a surgical emergency, I hereby give permission to the attending physician to hospitalize, secure proper treatment for, and to order anaesthesia or surgery for my child.

Permissions (please read carefully and check the box)

I understand that boating, water sports, and other camp activities have inherent risks beyond the contemplation and control of camp staff. Precautions are taken for the health and safety of your child, but in the event of accidental death, injury or illness, True Life Church, its staff and volunteers are hereby released from any and all liability. I give the leadership of this camp the authority to make medical decisions in my absence on my child’s behalf. In the event that any camper requires special medication, x-rays or treatment, parents/guardians will be notified immediately. In case of a surgical emergency, I hereby give permission to the attending physician to hospitalize, secure proper treatment for, and to order anaesthesia or surgery for my child.

Date of Parent/Guardian Signature (D/M/Y) *

Parent / Gaurdian *

First

Last

Date of Witness Signature (D/M/Y) *

Witnessed by *

First

Last

Waterski Camp Registration

2021 Registration Form

True Life Youth