Kids Camp 2017 June 5-8, 2017 from 6-8PM at Cassidy Elementary School Registration FORm Child Info Child's Name * First Name Last Name Birthday * MM DD YYYY Grade in school for Fall 2017 * 4K 5K 1st 2nd 3rd 4th 5th Allergies or other important medical info: Parent or Guardian Info Your Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Primary Phone * (###) ### #### Email * Emergency Contact (other than a parent) Name * First Name Last Name Relationship to Child * Phone * (###) ### #### Guest Information If you are not a member of TCPC, do you have a church home? If so, please type its name below: I was invited by... I would like my child to be in the same class as the family who invited us Yes No Medical Release MEDICAL RELEASE: It is my understanding that in the event of a medical emergency involving my child, every attempt will be made to reach me or the Emergency Contact Person I have listed on this form. If the church cannot reach me, then I authorize Tates Creek Presbyterian Church to employ a doctor or other healthcare professional, and I hereby give my permission to provide medical services that are deemed necessary. I understand that checking this box represents authorization of this Medical Release. * Yes, I authorize this Medical Release. PHOTOGRAPHY RELEASE PHOTOGRAPHY RELEASE: It is my understanding that TCPC may use photographs which include my child in future promotional materials on the TCPC website, Facebook page, and brochures. I understand that checking this box represents authorization of this Photography Release. * Yes, I authorize this Photography Release No, I do not authorize this Photography Release Thank you!
