faith, family, friends

Camp Registration

Name: *
Gender: *
Grade Completed in 2014: *
Student Cell Phone: *
Parent/Guardian Cell Phone: *

T-Shirt Size: *

Medical Release Form on File? *

Requested Roommates (2 Max):

Camp Rules

• Pack money and medicine for easy access upon arrival.
• Campers will be required to keep up with their money throughout the week. Medicine will be given to the camp nurse upon arrival.
• Campers are NOT to bring: valuable items, fireworks, halter tops, shorts higher than mid-thigh, unsuitable swim wear (see swim suit requirements), sleeveless shirts, tops exposing your midsection, any type of tobacco or alcoholic beverage, electronic devices (including cell phones),knives, water balloons, water guns, or shaving cream.
• The camp director reserves the right to search any camper’s belongings if suspicion arises.
• Shorts may be worn to all events.
• Tops and shirts must have sleeves.
• At least ONE shower per day required.
• Sweet hearts my not hold hands during worship or show other forms of PDA.
• Griping and bad attitudes will not be tolerated.
• Campers MUST keep their things in a clean, neat, and orderly fashion as determined by Clint and counselors.
• Parents will be contacted upon any questionable injury.
• Campers are to obey all rules set forth by Clint, Hunter, and the camp Staff.
• Anything broken due to breaking a rule will be fixed at the parent’s expense.
• A camper will be sent home at the parent’s expense if their conduct warrants.

Clothing & Bathing Suit Requirements

The goal of the week is to have an awesome time, while growing in a relationship with Jesus. In an attempt to take away any distractions, we are asking everyone abide by specific dress requirements.

Lake Requirements
• No bikinis- bring only appropriate one-piece or tankini suits. (appropriate means that mid-riff is not showing)
• Males: no speedos

Meals, Worship, etc.

• No tank-tops with straps less than 2 fingers wide
• No short shorts- rule of thumb will be: with your hands down by your side, if your fingers touch skin, you will be asked to change.
• No mid-riff shirts or other shirts that are revealing.

I Agree: *

Waiver of Liability

Rock Springs Baptist Church, Student Ministry, and Volunteers Are Designated By The Abbreviation “RSBC” Throughout This Entire Form
• I (we) hereby authorize RSBC to take my (our) child to the before named physician or facility for medical treatment in the event of an emergency in which neither parent can be reached.
• I (we) hereby give permission for my (our) child to attend and participate in activities sponsored by RSBC.
• I (we) hereby authorize RSBC to transport my (our) child to or from church and/or any other church related and sponsored activities and events.
• I (we) hereby authorize RSBC to include my (our) child in supervised water activities.
• I (we) hereby authorize RSBC and its acting leaders to teach and lead my (our) child in religious lessons and services which may include prayer and Bible teaching.
• I (we) hereby authorize an adult, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the medical practice act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at the said hospital.
• I (we) hereby do authorize any leader of RSBC to dispense to my (our) child any necessary over-the counter medications (according to proper dosage instructions) when deemed necessary.
• I (we) do hereby authorize any licensed physician or medical treatment center to treat my (our) child
in the case of emergency in which the before named physician cannot respond.
• The undersigned adult shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization.
• Should it be necessary for my (our) child to return home due to medical reasons or otherwise, the undersigned shall assume all transportation costs.
• I (we) hereby release, forever discharge and agree to hold harmless RSBC and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the undersigned adult and the child-participant that occur while said child is participating in any trip or activity with RSBC.
• Furthermore, I (we) [and on behalf of my (our) child-participant if under the age of 18 years] hereby assume all risk of personal injury, sickness, death, damage and expenses as a result of participation in recreation and work activities involved therein.
• Further authorization and permission is hereby given to said church to furnish any necessary transportation, food, and lodging for this participant.
• The undersigned further hereby agrees to hold harmless and indemnify said church, its directors, employees, and agents for any liability sustained by said church as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.
• The medical consent and liability waiver provisions hereof shall remain in full force throughout 2014 and in effect until written notice of revocation or withdrawal is received by RSBC at its office.
•  It is the responsibility of the parent or guardian to notify the church of any
changes in medical condition, guardianship, address or phone change.

I Consent: *

Behavior and Photo Consent

I take full responsibility for my child during all 2014 Rock Springs Baptist Church Student Ministry Events.
In the event of any personal or property damage done by my child, I understand that I
am morally, and financially responsible.

This includes:
• Negligent physical harm or injury inflicted to another individual by my child.
• Property damage to any and all objects done by my child.
• Transportation expense home for my child due to early dismissal from said event for
use or possession of alcohol, tobacco, illegal drugs, inhalants, and pornographic
• Transportation expense home for my child due to their inability to gain personal
control over any actions that may cause injury to oneself or another.
• Transportation expense home for my child due to their causing excessive and
persistent disruption to the entire group during said event.

All dismissal decisions are at the discretion of the Student Minister. In the event that
damage is caused by more than one child, equal responsibility is taken by all involved.
When responsibility for damage is not claimed, all those closely related will share in
responsibility and expense (example: room damage unaccounted for = all room
members share responsibility).

All final decisions are the responsibility of the Student Minister after discussion with all
volunteer adults involved. It is never our desire to send a student home and we will do
all we can to work with you, the parent, in impacting your child positively. When any
serious problem arises, you will receive a phone call so that the matter can be
discussed and the proper action taken.

I consent for my child’s picture to be taken and used for promotional material in the

I Agree and Consent: *

Turn the registration fee into Collide Student Ministry by July 27.