Christmas Camp

Child's Information

First & Last Name

Grade

Gender

Does your child have any medical conditions we should be aware of?

Does your child have food allergies or dietary restrictions?

Parent's Information

First & Last Name

This address will receive a confirmation email

Phone

Address

Agreements

In case emergency medical treatment is needed, I give permission to the staff of the First United Methodist Church of Round Rock, or anyone acting on its behalf, to obtain necessary emergency medical treatment, by a licensed physician, hospital or clinic for my child. In providing consent, I understand that FUMC-RR does not have a medical staff on campus and that all decisions regarding the need for emergency treatment will be based upon reasonable judgment of the FUMC-RR, or its designee. I release FUMC-RR, and its staff, from any and all liability, claims, demands or causes of action related to any loss, damage or injury which may occur while my child is attending camp.

I herby grant permission for First United Methodist Church of Round Rock to use photographs, voice recordings and video recordings (collective, the Images) of my child on the church-wide website, social media, electronic communique, displays and/or other official printed publications.

Emergency Contact Information

First and Last Name

Phone Number

Relationship

Payment

Cost $25

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Christmas Camp

Description

Please Fix the Following