Camp – Permission Slip / Packing List

Middle School & High School Summer Camp - August 7-9

Student Name*
First Last
Parent/Guardian’s Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Parent's Phone Number Or Emergency Phone Number*
Student's Health Insurance Company
Student's Health Insurance Number
PLEASE READ CAREFULLY AND FILL OUT COMPLETELY - I hereby give my permission for my son/daughter to participate in this activity. As the legal parent/guardian of the above, I assume all responsibility and full liability for any illness, disease, infirmity, or alteration in physical condition sustained by my son or daughter for any reason whatsoever. I hereby release Calvary Chapel Fremont and its employees and officers (including any drivers helping with the transportation of students for an activity) from any and all responsibility and liability in the case of illness, accident, injury, or death. I authorize any medical care deemed necessary by an accredited physician, nurse, paramedic, or hospital while in the aforementioned activity. In the event of illness, accident, or injury while my child is in the care of Calvary Chapel Fremont, I understand and agree that I am financially responsible for any care so provided. In the event that it becomes necessary or advisable for any reason whatsoever to alter the itinerary or arrangements, the leadership reserves the right to make such alterations. I understand that I will be required to pick-up the student listed on this form at the leadership’s request if my child’s behavior is contrary to the spirit and intent of this activity. The signing of this form by the parents or legal guardian shall be deemed consent to the above conditions
Consent*
I agree and consent to everything listed above
Email
This field is for validation purposes and should be left unchanged.

Packing List

* A sleeping bag
* Pillow
* Swimming attire
* Warm clothes
* Toiletries
* Reusable water bottle
* Bible, pen, notebook
* Medications
* Towel
* Camera (optional)
* Cash $$$ for dinner on way up and lunch on way home

boardgames (optional)

Camp – Permission Slip / Packing List

Middle School & High School Summer Camp - August 7-9

Packing List

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