Mega Camp 2025

Camper Name

Address

This address will receive a confirmation email

Phone

Is it okay to send text messages?

Yes No

Date of Birth (mm/dd/yyyy)

Parent Name(s)

Grade (Completed 2024-2025)

Kindergarten 1st 2nd 3rd 4th 5th

Activity Choice

Basketball Drama Science Soccer

Emergency Contact Name and Phone Number (This person will be contacted if the parent cannot be reached)

Please list any allergies (foods, medicines, insect stings, etc.)?

Does this child have any medical/health problems or chronic/recurring illnesses which would have an effect on the child's participation in MCC Mega Camp?Any medical concerns that we need to be aware of?

Yes No

If yes, please describe:

Any special needs that we need to be aware of?

Our Medical Information and Activity Consent Form can be found here. We must have this filled out and signed by a parent or guardian for your child to participate in Mega Camp. You will also be sent this in an email or it can be found on our website. You can email a signed copy to mstuart@mtcalvarychurch.com or bring it with you to the first day of camp.

By checking this box I am verifying that I have read and agree to the Activity Consent form found above.

Yes No

PHOTO AND VIDEO AUTHORIZATION:

Mount Calvary Church maintains a church web site (www.mtcalvarychurch.com), a Facebook page (https://www.facebook.com/mtcalvarychurch) and an Instagram account (https://www.instagram.com/mtcalvaryetown/). We may post pictures and/or videos of church activities. Pictures and/or videos may also be displayed on church bulletin boards and multimedia presentations and in church flyers/brochures/directories and in outside publications such as local newspapers. Because your child’s image may be included in these pictures and/or videos, we must obtain your permission to post these pictures and/or videos. Although children’s names may be used in publications, no other personal information will be posted.

Permission to take and use photos?

Yes, I give my permission for my child’s image to be included in photos and/or videos as outlined above. No, I do not give permission for my child’s image to be included in photos and/or videos as outlined above.

Parent/Guardian Signature. By typing my name below I am electronically signing this document. MCC will treat this like a physical handwritten signature on a paper form.

*Parent/Guardian Signature

Mega Camp 2025

Description

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