2021 Youth Summer Camp Registration

Student Information

Parent Information

Medical Information

Parent Permission Statement

I understand all reasonable safety precautions will be taken at all times by Summit Creek/Vine Community Church and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Summit Creek or Vine Community Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I also give permission for my 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 Summit Creek/Vine Community Church.

Student Code of Conduct

I understand that I am expected to cooperate with the staff and leaders of Summit Creek/Vine Community Church at all times and participate in all scheduled activities. Possession and/or use of alcoholic beverages/drugs/firearms is strictly prohibited. Failure to remain within these guidelines at any time is cause for my immediate return home at my parent’s/guardian’s expense. I agree to abide by the code of conduct.

Payment can be made through cash or a check made out to Summit Creek Church with the student's name in the memo, and placed in an offering box at Summit Creek.

Thank you! You will receive an email confirmation along with more information about camp within the next couple of days.

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