Men's Campout 2025

Under 18 Registration

* Indicates required field

Name *

First

Last

Grade *

Church you attend *

D.O.B (MM/DD/YY) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Camper's Medical Information

Physician *

Medications Currently Taking *

Physician Phone *

Instructions for Medications *

Can your child take over the counter medication? *

Yes No

Fellowship Baptist Church Camp Medical & Liability Release Statement
*I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on the registration form. In the event I cannot be reached in an emergency, I hereby give my permission to the physician or dentist selected by the camp director or ministry director to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child as deemed necessary.
*I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed. Coverage by Camp Fairview and/or Fellowship Baptist Church through its accident policy will be used as a back up for what my family's insurance does not cover.
*I understand all reasonable safety precautions will be taken at all times by Camp Fairview and/or Fellowship Baptist Church and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent risk. I agree not to hold Camp Fairview and/or Fellowship Baptist Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject on this form.
*I understand that Camp Fairview and/or Fellowship Baptist Church reserves the right to discipline or dismiss my child from camp with forfeiture of fees if he/she is non-cooperative or noncompliant.
*I further agree to indemnify and hold Camp Fairview and/or Fellowship Baptist Church harmless against any and all costs, damages, and expenses which may be incurred by them as a result of any claim I may make, actions I take against the camp, or lawsuits I may file against them.
*I give permission for my child's picture to be used in future camp publications, promotional videos and/or on the internet.
*I agree to the above Parent Medical and Liability Release Statement.

Have you read and do you agree to the above stated Medical and Liability Release? *

Yes No

Parent/Guardian Name *

First

Last

Date *

Submit

2025 Men's Campout

Adult Registration

Under 18 Registration

Camper's Medical Information

Loving Christ, Changing Lives