REGISTRATION

Please provide the best contact person and phone number for camp hours.

I hereby release Saint Barnabas Episcopal Church, its directors, officers, employees and volunteers from responsibility and liability for any injury or illness that my child(ren) may sustain during Saint Barnabas Arts Camp. In the event of an emergency, I hereby authorize an adult leader of this activity, as agents for me, to consent to any x-ray examination, medical, dental or surgical diagnosis, treatment and hospital care advised and supervised by a physician, surgeon, or dentist (as appropriate), licensed to practice under the laws of the state where the services are rendered, either at a doctor’s office or in any hospital. As a parent/legal guardian I expect to be contacted as soon as possible.

As a parent or legal guardian of the child/children I am registering, I grant permission for my child/children to participate in Saint Barnabas Arts Camp 2023. I give permission for photography of my child to be used on the Saint Barnabas website, Facebook page, newsletter, and other printed/digital publications for no purpose except that of promoting the life and community of Saint Barnabas Episcopal Church.

I certify that by typing my name below in the Electronic Signature Field and submitting this form, I intend to sign this document and be bound to the same extent as if I had provided a physical signature.