Dear FCC Kids and Parents,

Summer is just around the corner and with that comes camp. In this packet you will find all of the information and forms to sign your student up.

Camp is going to be amazing this summer and we are excited about the two camps we will offer for FCC Kids. The first camp is for our 3rd-5th Graders (based on grade as of Fall 2017) and will be May 30th—June 2nd at Lakeview Christian Camp. Lakeview Christian Camp is a great facility that continues to improve every year. The second is our K-2nd Graders (based on grade as of Fall 2017) which will take place at FCC on June 14th. During that day we will have all kinds of activities jammed into one exciting day. Through each of our camps they will get to experience games, worship, lessons, & all kinds of things that will make these some of the craziest days of their summer. This year for both FCC Kids Camps, our time will be focused on the theme “I Know It Sounds Crazy But It’s True!” We will talk about a few of the crazy events that took place in the Bible and what they mean for us today. Through our time at camp we hope these kids will fall in love with the Word of God in a crazy new way! A schedule is given below, with dates and costs for each camp. The cost varies for each camp, so refer to the chart for your camp cost.

To reserve your spot at camp for that discounted price, you must turn your forms and pay the full amount to FCC by May 7th. Any registrations turned in after May 7th, will have an increased cost. So make sure you get your forms and money turned in by May 7th! We are also offering a discount for the 3rd-5th Graders who brings a friend to camp who has never been to any FCC Kids Camp, CIY SuperStart!, or Lakeview Christian Camp before. We will take $25 off for you and your friend! (Discount only for 3rd-5th Grade Camp & only one discount per person)

We will send out more information prior to each camp about packing list, departure times, schedule, etc. We want every student to go to camp, so let me know if I can help in any way to accomplish that goal or if you have any questions.

God Bless,

Brooks WachsChildren’s Minister620.227.8686 (office) brooks@fccdc.com (email)

CAMPS DATES Before May 7th After May 7th

K-2nd Grade June 14th $15 $20

3rd-5th Grade May 30th—June 2nd $125 $150

Camper Name:

Date of Birth:

Age:

Gender: Male Female

Grade Entering in Fall 2017:

Camp Attending:____ K-2nd Grade Camp (June 14th)____ 3rd-5th Grade Camp (May 30th-June 2nd)

How did you hear about camp?____ Church____ A friend invited me—Name of Friend: ____ Bulletin/Newsletter____ Facebook____ Other:

Have you attended FCC Kids Camp, CIY SuperStart!, or Lakeview Christian Camp Before?____ YES ____NO

T-Shirt Size: YS YM YL YXL S M L XL 2XL

Street Address:

City: State: Zip Code:

Home Phone:

2017 CAMP REGISTRATION FORM

CONTINUE ON BACK

Parental Consent / Liability Release Form

To Whom It May Concern:• The undersigned does hereby give permission for our (my) child ____________________ to

attend and participate in activities sponsored by First Christian Church.• We (I) 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, in case of an emergency, 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 said hospital.

• The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the afore mentioned child pursuant to this authorization.

• We (I) do hereby release, forever discharge and agree to hold harmless First Christian Church and the directors and all church volunteers and sponsors thereof from any and all liability, claims or demands for personal injury, sickness, or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in any trip or activity sponsored by First Christian Church.

• Further, we (I) authorize and give my permission to First Christian Church to furnish any transportation, food and lodging necessary.

• The parents of the child identified on this form understand that if necessary, because of misconduct or disobedience, the child may be required to return home.

• Should it be necessary for our (my) child to return home due to medical reasons or otherwise, the undersigned shall assume all transportation costs.

• The undersigned does also hereby give permission for my (our) child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in activities sponsored by First Christian Church.

• The undersigned further hereby agree(s) 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.

• This Parental Consent / Liability Release Form shall be effective for a period of one (1) year.

Participant’s Signature Date

Parent/Guardian’s Signature Date

Photo/Video Release

I hereby give permission to First Christian Church of Dodge City to use any photographs or videos of my child taken by staff or volunteers to be used for related church activities,

programs, or promotions, including on its website and social media sites, by First Christian Church of Dodge City

Parent/Guardian’s Signature Date

Parent/Guardian Information:Father/Guardian Name:

Home Phone Number: Work Phone Number: Cell Phone Number: Email Address: In case of emergency what is the best way to reach you?

____ Email____ Home Phone____ Work Phone____ Cell Phone____ Text Message

Address:____ Same as AboveIf different:Street Address:City:_____________________ State:______ Zip Code:

Mother/Guardian Name: Home Phone Number: Work Phone Number: Cell Phone Number: Email Address: In case of emergency what is the best way to reach you?

____ Email____ Home Phone____ Work Phone____ Cell Phone____ Text Message

Address:____ Same as AboveIf different:Street Address:City:_____________________ State:______ Zip Code:

Other Emergency ContactName:_____________________________________Emergency Contact Phone:____________________

Person/Church Designated to Pick Up Child From Camp:________________________

Any Person Not Permitted to Take Child From Camp:___________________________

Additional Information:___________________________________________________

CONTINUE ON BACK

MEDICAL RELEASE / INFORMATION FORM

Camper Name:

Date Last Tetanus Booster:

Insurance Company:

Policy Number Group Number

Family Physician: Phone:

Physical, Medical, or Emotional Disabilities:

Other Medical History:

Allergies:

Camper Taking Medication: Yes No

Names of Medication(s)

Notes: