PLEASE USE THE FORM BELOW TO REGISTER CHILDREN FOR ATTENDANCE FOR ANY AND ALL DAY CAMP DATES. Bible Day Camp Registration Please complete a separate registration for every child that will be attending. Child's Name(Required) First Last Child's Age(Required)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian Name(Required) First Last Parent/Guardian Email Parent/Guardian Phone(Required)Emergency Contact(Required) First Last Emergency Contact Phone(Required)Date (or dates) registering for: Tuesday, June 13 Tuesday, June 27 Tuesday, July 11 Tuesday, July 25 Tuesday, August 8 Select All(Please select all applicable choices, or if registering for all dates, choose that option.)Please inform us of any special dietary needs or allergies for your child. If none, please type "None."(Required)Please inform us of any medical conditions your child has, or list any medications your child will bring with them. If none, please type "None."(Required)All medications must be sent in original prescription packaging with the child's name and dosage instructions.Emergency Medical Consent(Required) I hereby give consent to the provisions provided.In the event of a medical emergency, I hereby give Hatfield First Baptist Church my consent to administer appropriate first aid in case of minor injury or illness. If necessary, I further consent that the members and employees of Hatfield First Baptist Church may transport or authorize emergency transport of my child to an emergency room to receive such treatment as may be necessary to stabilize him/her until I can arrive. Hold Harmless Agreement(Required) I consent to the agreement herein specified.Understanding that the children will be playing games and engaging in friendly competition at times, and that children will be children, I agree to hold First Baptist Church Hatfield harmless and perpetually indemnify them from all claims, demands, lawsuits, causes of action, loss, liability, injury, or damage that may arise as a result of my child's voluntary involvement in normal scheduled activities. Excepted from this would be any damages resulting from the rare case of criminal activity or criminal negligence on the part of the church or its members.Sign In/Out Policy(Required) I agree to the Sign In/Out policy.I understand that, to insure the safety of every child, a parent or guardian must personally and physically enter the building in order to sign in or sign out their child. Drop offs without a parent/guardian signature will not be permitted and will result in a call to law enforcement for cause of abandonment. No child will be allowed to leave the building without being signed out by a parent or guardian. Δ