Lancaster County Victory Sports Camp

Lancaster County Victory Sports Camp

July6th- 10th

Sports: 9am-noon (Mon.-Fri.); Bible School: 1pm-4pm (Mon-Thurs.)

Registration Form – Lancaster Area Camp

Child’s name ______Male ______Female _____

Date of birth ___/_____/_____ Age ______Grade completed ______

Address ______

Parent or Guardian’s name ______

Best contact number ______(home or work)

Additional contact number (in case of emergency) ______

Do you attend church? Yes or No if so, name of church ______

Please circle which sports you are interested in:

Baseball/Softball Basketball Football Volleyball Cheerleading Soccer

Does your child have any health problems (allergies or physical injuries)? Yes or No

If so, what? ______

Is your child on any medication at this time? Yes or No

If so, what? ______

Will you child need transportation? Yes or No Pick up address: ______

As the parent or legal guardian of the above-named child, I understand that participating in Lancaster County Victory Sports Camp presents risks of death, personal injury, and property damage. These risks include, but are not limited to, those caused by terrain, facilities, equipment, temperature, weather, the health of participants, and the actions or omissions of other people. With this understanding, I assume all risk related to my child’s participation in the Sports Camp. In consideration of their allowing my child to participate, I agree to hold harmless and release from liability Barr Street School or Buford High School and all churches, organizers, sponsors, supervisors, and agents of the Sports Camp for any death, injury, property damage, or other loss relating to my child’s participation, including travel to and from the Sports Camp.

I understand that the Sports Camp will include religious teaching and activities, including music, games, and crafts, that are based on the Bible and Jesus Christ. I give permission for my child to participate in these activities.

I give permission to Barr Street School/Buford High School and all churches, organizers, sponsors, supervisors, and agents of the Sports Camp to produce videos, photographs, and other forms of media that may include my child for the purposes of promotion, advertisement, or other information concerning the Sports Camp.

______

PARENT and/or GUARDIAN SIGNATURE DATE

Registration cost is $25.00 (make checks payable toMoriah Baptist Association – Memo: Victory Sports Outreach)

Mail or deliver forms to Moriah Baptist Association, 914 W Meeting St.,Lancaster, SC 29720

For more info contact:

Brad Kirkley

Phone: 704-361-4815 Email: