* Indicates required information
PLEASE NOTE: Due to overwhelming demand our JK/SK Groups for July 21-25 is full. We will move any new registrations for these age groups (week 1) to a wait list as of May 6th. If you are registering a child inJK-Sk Week 1 for our waitlist we ask that you DO NOT pay (hit pay later) until we can provide a spot for your child. NOTE: Other age groups still have room to register. Thank you for your understanding.
Be aware that this form is NOT completed until you hit the SUBMIT button at the very bottom of this form.
If you do not receive the confirmation email within an hour of completing the form then please contact the office at 519-352-4220
Reminder:
Evangel will supply peanut free snacks for morning and afternoon. Children must bring their own peanut free lunch(es).
Medical Release
In the event of an emergency where medical treatment is required; I give permission to the church staff to obtain the service of a licensed physician. Every attempt to notify parent or guardian immediately concerning any such emergency will be taken.
Waiver Release
Waivers - I/we, the parents or guardians named below, authorize the ministry staff of Evangel Community Church to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above in case of medical emergency.
I/we, named below, undertake and agree to indemnify and hold harmless Ministry Personnel, Evangel Community Church, its employees and volunteers from and against any loss, damage or injury suffered by the supervising individuals representing the Church. This consent is effective only when participating in or traveling to events sponsored by Evangel Community Church.
I/we, the parent or guardians named below are aware that the potential contact of viruses in this large group setting may occur. I/we understand and accept the risk.
My child(ren) may be photographed/videotaped for church use and promotional purposes (including but not limited to church website and social media platforms). Purposes and Extent - Evangel Community Church is collecting and retaining this personal information for the purpose of enrolling your child(ren) in our various programs, to assign the student(s) to the correct classes, to develop and nurture ongoing relationships with you and your child(ren), and to inform you of program updates and upcoming opportunities at our Church. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Evangel Community Church to limit the information collected, or to view your child's information, please contact us.
By entering your name in the space below, I confirm that I am a parent and/or guardian for the above mentioned child(ren) and I give permission for my child(ren) to attend Evangel Community Church's Day Camp program(s).
You are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
Payment Information for Day Camps.
The cost is $30 per child/per camp for the entire week to a max of $90 for 3 or more per week - all from the same residence.
There are three options for payment:
1. Payment by credit card - fill in below
Select Pay Later for the following options:
2. e-transfer to evangel@evangelck.com - put in the Note Section your child(rens) name and the camp date.
3. Drop your payment off at the office - Monday - Thursday 9 a.m. to 4 p.m.
Note: If you choose to Pay Later then we cannot guarantee a space for your child until payment is received.
Late Payment Fee: The cost will increase to $40 per week per Camp after July 7 for week 1 or July 28 after week 2
Refund Policy
Refunds will not be given after 14 days prior to the beginning of the camp July 7 for camp July 21-25 and July 28 for camp Aug 11-15.
If you have any questions email: bfitch@evangelck.com
