Register for PCOC Branching Out Kid's Camp Here!
June 19th -23rd, 9 am-12pm 
Your only cost for this camp is a $10 registration fee!
Let's Go!
 
What's your first name? *

 
Hey {{answer_zY1W}}, nice to meet you.
What's your last name? *

 
Name of Participant

*

 
Participant Grade *

As of August 2017

 
Contact Information *

In case of emergency, what phone number can we best reach you?
 
General Release of Liability *

This child has my permission to participate in the various Kid's Camp activities (learning stations, snack, large  and small group times, and all activities).    I further give my permission for the church representatives, Highlands Presbyterian Camp, or leaders of the activities to secure necessary medical treatment for this child at an appropriate medical facility as deemed necessary in the event that I (or those responsible adults named on the registration form) cannot be reached for such permission.   I release Presbyterian Church of the Covenant and its representatives from any liability for accident or injury during these activities.  I waive and release any and all rights and claims for damages I may have against Presbyterian Church of the Covenant for any and all injuries, if they should occur, suffered by my child(ren) while they are attending Kid's Camp.

Authorization Signature below (Type Full Name)
 
Emergency Medical Care *

Please provide Medical Insurance Carrier, Group, Policy, and Contact number below
 
Photo Release *

I give permission for my child to be photographed (to be used during slide show presentation of the week, posted on church website, church Facebook page, and/or bulletin board displays in Children’s Ministry) during Kid's Camp activities.
Initial below
 
Allergies

Does the participant have any allergies, including food sensitivities? If so list below. If not click enter.
 
Specific Notes

Are there any disabilities, special conditions, or medications with the participant?
 
T-shirt *

What is the participant's t-shirt size?

 
Anything else to know?

Is there something else to know about the participant?
 
Pick-up

Person(s) other than parent authorized to pick up participant.
 
Pick up

Person(s) NOT authorized to pick up participant.
 
Thank you!

Check IN: Monday June 19th, between 8:45-9:00 am.  

$10 Registration Fee: may be mailed-in or given at church.
5400 South Yostemite Street Greenwood Village, Co 80111

So excited to have you with us at PCOC for the week!

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