Example: 00/00/0000 (include slashes)

Please notify the church you are traveling with after you complete this form to arrange travel plans and payment of the camp fee.

All campers currently taking medications must report to the Camp Nurse upon arrival at camp. 
Bring medications to camp in their original containers. 
You may also list any over-the-counter medications that you would give the nurse permission to administer to your student for minor medical conditions.

Permission to Attend Camp
I understand all the rules and regulations of the camp and have reviewed them with my student.   I understand that if my student does not abide by the rules that I will be contacted by the camp staff to pick my student up early from camp. I grant permission for my student to participate in all supervised activities including water activities.  I will contact the camp leadership before the start of camp to notify them of any necessary restrictions.  

Photo Use Release
I give consent and authorize New Life Baptist Association, any affliated church, or Grand Oaks Camp to use pictures and videos that may include my student in them for promotion and other publications.  I understand that this may include, but not be limited to, the use of digital photo images and videos to be used for display and publication on websites, newsletters, and other publications.  The student's name shall not appear in or on the published materials unless further approval is given by the parent/guardian.  I further release the camp leadership from any and all claims of any nature arising from use of the digital images.   

Permission for Medical Treatment:
I give my permission to the camp nurse and camp staff to obtain necessary medical attention in case of injury or sickness to my student, understanding that they will attempt to call the phone number(s) I provide on this form.  I give permission for the camp nurse to administer the above medications.  I verify that the above information is correct and relase the New Life Baptist Association, Grand Oaks Baptist Assembly, and staff from any and all claims of damage or injury while participating at camp.  I also understand that the insurance provided by Grand Oaks Baptist Assembly Inc. and any affliated church is a limited supplemental policy covering only injury or accident occuring during the events at Grand Oaks.  Even then it will be used only to supplement my personal health insurance.  Checking the box below and my signature on this form shows my compliance.

*By entering my digital signature in the box above I agree that all information provided is accurate.  I give permission for my student to attend Church Camp.