Summer Camp Registration Form 

Printable Version
To save time, feel free to use this form to register your child for Summer Camp.

Payments can be made once you submit the form to us on the website you are redirected to.

If there is missing information on the form that we need, we will contact you to get the necessary information so please provide a valid email address and phone number.

Please note that other forms may need to be signed in person before we will be able to have your child depart with us to Camp. These forms are available for download after completing this form. 

Camp Cost: $80 per camper

The completion of this form will register your child for camp. Please remember that the tuition fee for the camp must be collected prior to us arriving at camp unless other arrangement have been made. You can use the email link at the bottom of this form to contact the Camp Coordinator if the need arises.

By registering for camp, you agree to the following:

Program Participation, Medication Permission & Medical Consent/Release

I, the parent or guardian of the camper named on this form, give my permission to authorized personnel of Timberlake Baptist Church to distribute over-the–counter remedies or medications for minor needs such as: headache, fever, minor pain, minor allergic reactions, upset stomach, minor injuries; and, to dispense prescription and over-the-counter medication designated and provided by the parent/guardian or family physician.

I, having the authority to consent for the minor’s health care, do hereby delegate my authority to consent to said minor’s care (named on this form) to Timberlake Baptist Church. I grant permission for the caregiver to request and authorize any and all examinations, medical treatments, and/ or procedures to or for the benefit of the minor as may be deemed advisable or appropriate by any physician licensed to practice medicine. I understand however that every effort will be made to contact me in case of such emergency and if possible, before any such medical treatment is administered. Furthermore, I understand that completion of this form with my email acting as an electronic signature grants permission for the named camper to participate in Timberlake Baptist Church programs. I also understand that camp insurance coverage is secondary coverage and I am responsible for any medical cost that may occur on behalf of the camper. I release Timberlake Baptist Church staff, faculty, officers, and management from any liability and shall not hold them responsible for any lost, stolen or misplaced personal property. Timberlake Baptist Church is hereby granted to use video, audio, and photographic materials of named camper, taken while participating in or attending a camp program, to promote and market Timberlake Baptist Church and its ministry.

Please note: Due to Health Code Regulations, all campers and staff are required to be inspected for the presence of head lice prior to departing for camp. Other precautions like checking their temperature may be required due to Covid-19 control protocols.

Waiver of Liability Relating: Coronavirus/COVID-19

On March 11, 2020, The World Health Organization declared the novel coronavirus, COVID-19, a pandemic. COVID-19 is highly contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people over the past several weeks. Timberlake Baptist Church (the “Ministry”) has put precautions in place to reduce the spread of COVID-19; however, the Ministry cannot guarantee that you or your family, including your child(ren), will not become exposed to or infected with COVID-19. Further, because of the number of individuals involved in [name of activity] and the fact that many infected individuals appear to be asymptomatic, attending this activity could increase your and your child(ren)’s risk of contracting COVID-19.

By agreeing to this waiver, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19. I also acknowledge that by attending [name of activity], such exposure or infection may result in personal injury, illness, disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at [name of activity] may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Ministry employees, contractors, volunteers, members, and participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense of any kind that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Ministry  or participation in [name of the event] (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the  Ministry, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Ministry, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any program.

By pressing the “Signup” button, you are expressing agreement with the waiver listed above.