Timberlake Students: High School Summer Camp 2024

Discount code

Registration type

$389.00

Student

FREE

Leader

Prices are in USD.

Who’s this registration for?

First name

Last name

Email address

Contact phone

Parent/Guardian Info

Fill this information out for the *PARENT/GUARDIAN* responsible for the student joining us at camp!

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone Number

Parent/Guardian Email Address

Secondary Emergency Contact First & Last Name

Secondary Emergency Contact Phone Number

Additional Student Info

Fill this information out for the *STUDENT* that will be joining us at camp!

Full Mailing Address (Stress Address, Apt #, City, & Zip Code!)

Timberlake Campus You Usually Attend:

School You Attend

Grade (for Fall 2024)

9th 10th 11th 12th I'm a Leader!

Gender

Student You Would Like To Room With

Insurance Information

Physician's Name

Physician's Phone Number

Insurance Company

Insurance Policy/Group #

Allergies, Special Needs, & Additional Information

Timberlake Waiver

The above student has my permission, as parent/guardian, to attend this function with Timberlake Church. I agree that Timberlake and/or its leaders are not liable for any accident related to either the planned event or transportation to or from that event. Nor are they liable for any injuries sustained or any lost, stolen, or damaged articles. I also agree that my child will be responsible to Timberlake Church and its leaders for all of his/her actions on this event. I authorize Timberlake and any adult leader to obtain the services of a physician and/or hospital for the care of my child, if necessary, including emergency medical care, emergency x-rays, and/or emergency surgery. Should the need arise, I also authorize Timberlake Church and its leaders to incur any necessary expenses for such services in the event of accident or illness, and I agree to provide payment for those expenses.

I Agree To These Terms

Booking details