JOIN US THIS YEAR FOR OUR MIDDLE SCHOOL SUMMER CAMP!

We are so excited about the opportunity to take our Middle School Students to Camp Mizpah near White Sulphur Springs. This will be for kinds ENTERING 6th through 9th grade!

June 17th through 19th

The cost is $150 per student.

Please fill out the form below to register:

Student's Name

First Name

Last Name

Grade Entering Next School Year (Aug 2024)

Mom's Name

First Name

Last Name

Mom's Phone

(###)

###

####

Dad's Name

First Name

Last Name

Dad's Phone

(###)

###

####

Email

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Allergies/Instructions

EMERGENCY AUTHORIZATION: If I cannot be reached I, the undersigned parent or legal guardian of the participant, hereby authorize the teachers, assistants, and event staff as my agents to consent to medical treatment in the case of an injury or medical emergency. WAIVER OF LIABILITY AND DISCLAIMER: I, the parent or legal guardian of the participants, acknowledge that participation in this event involves the risk of injury. I further acknowledge that this event is primarily administered by volunteers. In consideration for accepting the registration for the participant listed and for permitting voluntary participation of the said individual in its programs, I herby release, discharge, and hold harmless, the event staff its sponsoring organization, its employees, volunteers, and other representatives from any claims arising out of or related to any physical injury that may occur to the said individual while participating in this event. PHOTOGRAPHY DISCLOSURE: I acknowledge that pictures will be taken of the event and its participants and I grant permission for them to be used for the promotional purposes of Big Sky Fellowship.

Parent/Legal Guardian Signature

Date

MM

DD

YYYY

Please know that your registration is not complete until $150 payment is made. To pay, please give your cash or check to Big Sky Fellowship’s offering box clearly labeled “Middle School Sport Camp” in the check memo or place in an envelope.