CentriKid Camp 2023 (rising 3-6 grade)

July 24-28, 2023 | Must complete 1 form for each child attending camp. Please fill out this form, and click the "Submit & Pay" button.
For more information please contact our Director of Family Ministries, Bekah Seward at bekah@visitwellspring.com.
The deadline to register is Friday, June 23.

At CentriKid this summer, kids will learn that what we see on the surface seems important- appearances, grades, and accomplishments- but God's Word shows us that there is something that matters even more, something beyond the surface. God sees, knows, and cares about our hearts. He can give us a new heart for Him, a pure heart that is humble, trusting, merciful, and willing to follow hIm whereever He leads. We will journey BEYOND THE SURFACE this summer to explore the realm of what really matters: a heart for God. 

CentriKid camp is for rising 3rd-6th graders (23/24 school year).
Child Information

Please fill out the child's information below.
 
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Medical & Insurance Information

Please fill out child's medical and insurance information below.
 
 
 
 
 
 
 
Primary Parent/Guardian Information

Please fill out the primary parent or guardian's information here. 
 
 
 
 
 
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Secondary Parent/Guardian/Emergency Contact Information

Please fill out the secondary parent/guardian or other emergency contact information here.
 
 
 
 
 
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Parent/Guardian Authorization, Consent, and Release

I, ____________________________, parent/guardian of ______________________________, hereby grant my permission for the above-named child to participate in CentriKid, sponsored by Wellspring Church (the “Church”), July 24-28, 2023 (the “Event”). 
I understand the Event may include, but is not limited to the following: transportation provided by the Church to and from the Event, meals, and lodging. Recreation and activities during the event may include, but are not limited to the following: Bible teaching, worship, prayer, indoor and outdoor activities including water activities and physical exercise. 


I understand it is my obligation to inform the Church of any and all health considerations or medical conditions that would restrict my child’s participation in any and all activities while in the care of the Church. Should the need for medical attention arise I understand the Church will attempt to contact me as soon as practicable under the circumstances.


In cases of emergency, I further consent to the examination and treatment of my child by medical personnel as deemed necessary by such personnel. I agree to pay for any and all resulting medical expenses. I agree to waive, forever discharge, covenant not to sue and agree to hold harmless all Event volunteers and the Church, their agents, representatives, employees, sponsors, successors and assigns (“the Released Parties”), from all liability, claims, demands, losses or damages on account of or caused by, whether actual or alleged, in whole or in part, any act or omission of the Released Parties in connection with my child’s participation in the Event.


I acknowledge by signing this document I am waiving my right to maintain a lawsuit against the Released Parties on the basis of any claim from which I have released them herein. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions remain in full force and effect. I have fully informed myself as to the contents of this PARENTAL AUTHORIZATION, CONSENT AND RELEASE by reading it before I signed it.

By typing your full name and the current date, you are electronically signing this form and acknowledging that you have read the above Parent/Guardian Authorization, Consent and Release, that all repsonses in this form are true, and that your online consent is equivalent to a binding legal signature.
 
 
Payment

 
 
 
 
 
 

Description

July 24-28, 2023
Must complete 1 form for each child attending camp. Please fill out this form, and click the "Submit & Pay" button.
For more information please contact our Director of Family Ministries, Bekah Seward at bekah@visitwellspring.com.
The deadline to register is Friday, June 23.