BCBC 2026 Agape Day Camp Registration

First name:

Last name:

Gender:
MaleFemale

Birthdate:

Health Card information:

Address:

Camp T-shirt size:
YSYMYL

Before and after camp hours care needed?(7:45-9:00am, 4:00-6:00pm):
YesNo

Name:

Contact email:

Contact phone number:

Other people who are allowed to pick up your child and relationship to the child. Please list First name Last name and relationship

Food or other allergies:

Special concerns that the camp leaders should be made aware:

Please list any medications that your child is currently taking. Important Note: If your child requires medication while at camp we ask that you make arrangements to administer the medicine throughout the day. We will not administer any medicine of any type for children at camp.

Are there any other problem’s that may affect your child’s ability to participate in camp activities?

DISCLAIMER: 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 of the medical information provided in this form is true and accurate-lacking nothing. I hereby release my child to the care and medical discretion of the staff at Brampton Community Baptist Church and volunteers. 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. Please enter Parent/Guardian First name and Last name and Date below
Yes

Medication: Camp workers do not give or apply any medication to campers except bandages for minor cuts/abrasions or ice packs for bumps. Only the parents/guardians of the camper can give medication. If the camper requires special medication, x-rays or treatment, the parents/guardians will be notified immediately. Behavior: If the camper’s behavior is disruptive and disrespectful, the camper will be dealt with appropriately, including the option of contacting the parents/guardians and/or sending the camper home at the expense of the parents/guardians.
Electronic devices and toys: Electronic devices and toys are not allowed to be brought to camp. If they are brought to camp, they will be taken away and returned at the end of the week. Cell phones may be signed in to camp leadership for emergency purposes.
Photos and video: Photos and videos may be taken at designated times and events by camp workers. Photos or videos taken for camp purposes will never be published with names (unless parental permission is obtained). I understand that photographs and video recordings may be taken by Brampton Community Baptist Church camp volunteers which may be used in publications or promotions and I consent to use the images for all stated purposes.
By check this box, that I have read and agree the camp policy above.

By typing my name below, I release and forever discharge, the Brampton Community Baptist Church, the group leaders, directors, trustees, officers, employees, camp teachers and other representatives and volunteers from any and all damages and causes of action either at law or in equity that I may have as a result of my, or that of my child, participation in, attendance at, and travel to and from the event. Furthermore, I do hereby expressly stipulate, and agree to indemnify and hold forever harmless , the Brampton Community Baptist Church, the group leaders, directors, trustees, officers, employees, and other representatives and volunteers against loss from any and all present or future claims, demands, or actions in law or in equity that may hereafter be made or brought by myself, my child, or by anyone else on their own behalf for damages or any other legal or equitable remedy on account of any injury, illness, physical condition, inconvenience, or loss sustained by myself, or my child during the aforementioned event or travel to and from the same. Please type your First name and Last name and date below.*
By check this box, that I have read and agree the camp waiver carefully.