Incredible Me

This is for children going into 1st-5th grade or 6-11 years of age, July 16th - 19th, 8:00 AM -7:00 PM.

Thank You, we have received your form.
    July 16 - 19, 2018
    @8:00 AM - 7:00 PM
    Attendee
  • Parent / Guardian
    Parents, please fill the below are out.
  • Relationship to the Child

  • ALTERNATE PHONE

  • DO YOU ATTEND THIS CHURCH

  • IMPORTANT INFORMATION

    Parents/Guardians: When you arrive at church you will be required to check your child in before you leave, check in begins at 7:00 AM at the upstairs main church enterance. You will also be required to check your child out at the end of the day beginning at 7:00 PM, also at the upstairs main enterance. Please DO NOT drive around to the back of the church for the safety of the children that could be outside.

  • Waiver

    I give approval for my child to attend the WFLC Day Camp, to participate in all activities, and relieve WFLC Church and all its affiliated staff from any and all liability for sickness, accidents, or injuries while attending or being transported to/from the WFLC and Willow Springs City Pool and anywhere else we may need to trasport them. In the event of an emergency and I cannot be contacted, I give my consent to the Day Camp Director and the Day Camp Nurse to authorize medical help on site or at an appropriate medical facility. I give permission to the staff to use pictures / video of my child for the purpose of promoting the camp experience.

  • Attendee
    Please complete all fields below
  • Age

  • BIRTHDATE

  • In case of emergency, notify: Name & Phone

  • EMERGENCY CONTACT PERSON RELATIONSHIP TO CHILD

  • THE FOLLOWING PERSON(S) ARE AUTHORIZED TO PICK MY CHILD UP: NAME & PHONE

  • LIST FOOD ALLERGIES (IF NONE WRITE NONE)

  • MEDICAL CONCERNS WE SHOULD KNOW ABOUT (LIST BELOW IF NONE WRITE NONE)

  • MY CHILD WILL NEED THE FOLLOWING MEDICATIONS WHILE AT WFLC DAY CAMP (If none, write none)

  • Important Note Concerning Medications
    All medications must be brought in their original container. Please provide dosage and frequency information above.
  • T-Shirt Size

  • If other, please specify:
  • Van rides are available by necessity and availability ONLY&nb

  • Grade entering