After submitting the information for one child, select "Return to form" in order to fill out information for another child. 

Please provide an emergency contact in the event that parents/guardians are not available.  

By proceeding with this form you are agreeing to the Liability and the Emergency Aid Release waiver related to Maple Avenue Baptist Church.

Emergency Consent
I confirm I am the legal guardian of the camper with full authority to make decisions with respect to the care, upbringing, and education of the applicant. I agree that all the medical information provided on this form is true and accurate . I hereby release my child to the care and medical discretion of the staff and volunteers at MABC.  In the event of an emergency and that no one can be immediately contacted, my child will be taken to the hospital or a physician to be treated if deemed necessary by one of the camp staff , church staff or volunteers.  I hereby authorize the physician and nursing staff to undertake examination, investigation and necessary treatment of my child.

Liability Release
I acknowledge and understand there are risks involved with my child’s participation in the camp activities, including the risk of physical injury or damage to personal property and  I release MABC and all camp staff and volunteers from liability.

I acknowledge the contagious nature of COVID-19. I voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending MABC’s VBS and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at MABC’s VBS may result from the actions, omissions, or negligence of myself and others, including but not limited to MABC employees, volunteers, and program participants and their families. On my behalf, and on behalf of my children, I hereby release MABC, its employees, volunteers from all liabilities and claims.

By entering my name in the box above, I am providing my digital signature on this form.

I understand that photographs and video recordings may be taken by MABC which may be put on the church website or collected in a slideshow to be viewed at the end of camp and church on Sunday.  I consent to MABC using the images for all stated purposes.

NOTE: If you do not consent, please speak with Camp coordinator before event to make arrangements.

Registration Fee: $40/Camper