Summer Heat Sports Camp

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Parent/Guardian Phone#

Address

Child #1 Name (First and Last)

Birthdate

Grade (Entering September 2026)

Please list and explain any medical concerns, allergies, or neurodivergent diagnosis

Child #2 Name (First and Last)

Birthdate

Grade (Entering September 2026)

Please list and explain any medical concerns, allergies, or neurodivergent diagnosis

Child #3 Name (First and Last)

Birthdate

Grade (Entering September 2026)

Please list and explain any medical concerns, allergies, or neurodivergent diagnosis

Child #4 Name (First and Last)

Birthdate

Grade (Entering September 2026)

Please list and explain any medical concerns, allergies, or neurodivergent diagnosis

As the guardian you agree to the reasonable use of pictures containing the child/children named above in any of the following ways: brochures, promotional material, church power points, bulletin boards, FCC social media and the FCC website.

I, the parent or guardian named in this application, authorize the ministry staff of Family Christian Centre to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the child/children named above. I undertake and agree to indemnify and hold blameless the ministry staff and volunteers, Family Christian Centre, its pastors, and Pastor’s Council from and against any loss, damage or injury suffered by the child/children as a result of being part of the programs of Family Christian Centre as well as of any medical treatment authorized by the supervising individuals representing the church. I have read, understood and agree with the above and sign it to cover my child(ren)’s participation in all Children’s Ministry activities through Family Christian Centre for the 2026 program year effective as stated above.

Please click the appropriate payment amount for the number of children you are registering.

All payments are non-refundable

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Summer Heat Sports Camp

Description

Please Fix the Following