registration packet
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Questions? Contact Dustin Warford, Children’s Pastor at 925.228.8156 Or Email [email protected]
What to Pack Sleeping bag Flash light Pillow PJ’s Undergarments (at least 4 of each) Toiletries Towels 2 one for swimming and one for shower Modest swim suit (no bikinis) Sun screen At least 4 pairs of pants or sweats (am and pm are cooler) Shorts Sweat shirt Jacket At least 4 shirts Sneakers are a must for hikes Medications= Give all medications with instructions the day we are off to camp at the registration table. Fill out office form. Turn in form with your registration pack. Money for ropes courses, Zipline (3 different courses $10 each), and Lazer Tag. ($10 for an hour and a half session) Snack bar and gift shop money= prices range from .50 small candy- $2.50 Ice cream, nachos for snacks, Gift shop $2 small trinket, ($15-20) Tshirts and $35 -$40 sweatshirts. For those that will not be in charge of their own money. Please put money in separate plastic baggies per day. Your child’s counselor will be responsible for dispersing funds. For Fun surprise your child with a care package and a card form you Stationary and envelopes marked with address and stamped to be mailed out. Bible Pen Note pad
No battery or electronic devises are allowed (iPhone, droid phones, iPods, PSP, Nintendo 3ds, etc…) Thank You
CREEKSIDE CHURCH General Consent / Medical Release Form Name:___________________________________ Birthday:_______________ Sex:_____ Address:________________________________ City:___________________ Zip:______ Phone:__________________ Pager/Cell: ___________________ E-mail: _____________
HEALTH INFORMATION In case of emergency, notify: Name:_______________________________________ Home Phone:_______________ Work Phone:_____________________ Cell:_____________________
Known Allergies: Medications:________________________________ Food:_________________________ Other:_______________________________________________________________ Are immunizations up to date? _______ Medical Insurance:________________________ Medical Number:______________________ Dr.’s Name:__________________________ List any health problems:____________________________________________________ ________________________________________________________________________
CONSENT To the best of my knowledge, the above child is healthy and fit to participate in activities sponsored by Creekside Church. I understand this general consent/medical release form will be used for all activities at Creekside Church. I will not hold responsible the attending adults, church or church staff for accidents, sickness or emergency treatment incurred while attending the aforementioned activities. In case of emergency, I understand that every effort will be made to contact the parent or guardian listed above. In the event that contact cannot be made, I give permission to the attending adult(s) and the physician available to secure treatment urgently needed. Signature:___________________________________________ Date:_______________ Relationship to child:_______________________________________________________ NOTE: ONLY LEGAL PARENT OR GUARDIAN MAY SIGN THIS CONSENT/RELEASE FORM
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Questions? Contact Dustin Warford, Children’s Pastor at 925.228.8156 Or Email [email protected]
What to Pack Sleeping bag Flash light Pillow PJ’s Undergarments (at least 4 of each) Toiletries Towels 2 one for swimming and one for shower Modest swim suit (no bikinis) Sun screen At least 4 pairs of pants or sweats (am and pm are cooler) Shorts Sweat shirt Jacket At least 4 shirts Sneakers are a must for hikes Medications= Give all medications with instructions the day we are off to camp at the registration table. Fill out office form. Turn in form with your registration pack. Money for ropes courses, Zipline (3 different courses $10 each), and Lazer Tag. ($10 for an hour and a half session) Snack bar and gift shop money= prices range from .50 small candy- $2.50 Ice cream, nachos for snacks, Gift shop $2 small trinket, ($15-20) Tshirts and $35 -$40 sweatshirts. For those that will not be in charge of their own money. Please put money in separate plastic baggies per day. Your child’s counselor will be responsible for dispersing funds. For Fun surprise your child with a care package and a card form you Stationary and envelopes marked with address and stamped to be mailed out. Bible Pen Note pad
No battery or electronic devises are allowed (iPhone, droid phones, iPods, PSP, Nintendo 3ds, etc…) Thank You
CREEKSIDE CHURCH General Consent / Medical Release Form Name:___________________________________ Birthday:_______________ Sex:_____ Address:________________________________ City:___________________ Zip:______ Phone:__________________ Pager/Cell: ___________________ E-mail: _____________
HEALTH INFORMATION In case of emergency, notify: Name:_______________________________________ Home Phone:_______________ Work Phone:_____________________ Cell:_____________________
Known Allergies: Medications:________________________________ Food:_________________________ Other:_______________________________________________________________ Are immunizations up to date? _______ Medical Insurance:________________________ Medical Number:______________________ Dr.’s Name:__________________________ List any health problems:____________________________________________________ ________________________________________________________________________
CONSENT To the best of my knowledge, the above child is healthy and fit to participate in activities sponsored by Creekside Church. I understand this general consent/medical release form will be used for all activities at Creekside Church. I will not hold responsible the attending adults, church or church staff for accidents, sickness or emergency treatment incurred while attending the aforementioned activities. In case of emergency, I understand that every effort will be made to contact the parent or guardian listed above. In the event that contact cannot be made, I give permission to the attending adult(s) and the physician available to secure treatment urgently needed. Signature:___________________________________________ Date:_______________ Relationship to child:_______________________________________________________ NOTE: ONLY LEGAL PARENT OR GUARDIAN MAY SIGN THIS CONSENT/RELEASE FORM
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