Please upload a picture of the front and back of your insurance card.
If you do NOT have insurance, please contact the office so we can help you process your form. 706-795-3718
Parent or Guardian Information
Emergency Contact Information (Not the Parents/Guardians)
Person(s) Authorized to Check Out Camper
In addition to the parent(s)/guardian(s) listed above, by submitting this form, you authorize Trinity Baptist Church to allow the individuals listed below to pick up your child.
By clicking the below check box, I agree to release all liability from Trinity Baptist Church (members and volunteers) if my child is injured in any way during camp activities. I also grant permission to Trinity Baptist Church personnel to seek emergency medical treatment for my child should it be needed. I understand that they will make every reasonable effort to contact me or another emergency contact that I provide.
By clicking the below check box, I agree to the following:
• I hereby release, absolve, indemnify, hold harmless, and forever discharge Trinity Baptist Church, its employees, agents, organizers, sponsors, or any supervisors appointed by them from any and all claims, demands, actions or cause of actions, past, present, or future arising out of injury or damage to my child while participating in any activity, event, retreat or trip.
• I assume all risks and hazards incidental to the conduct of the activities, events, retreats or trips and transportation to and from these activities, events, retreats or trips. In case of injury to my child, I hereby waive all claims against Trinity Baptist Church, its employees, agents, organizers, sponsors, or any supervisors appointed by them. I likewise release from responsibility any person transporting my child to and from said activities, events, retreats or trips.
• I agree that any dispute, claim, questions, or disagreement arising out of or relating to said activities, events, retreats or trips, which cannot be otherwise resolved shall be submitted to mediation and if necessary legally binding arbitration as adopted by church leadership. As a result, I expressly waive any and all rights at law and equity to bring any civil matter before a court of law, except that judgment upon the award rendered by the arbitrator may be entered in any court have jurisdiction thereof.
• I agree to provide medical insurance for my child and/or agree to be responsible for any possible medical bills associated with my child.
To pay offline, select the option above that says "Pay Offline $0". If offline payment is desired, you need not fill out any credit card information. Instructions to make your offline payment are below.
Offline payment can be dropped off at the church office or mailed to: Trinity Baptist Church P.O. Box 618 Danielsville, GA 30633 Make checks payable to Trinity Baptist Church (mark Kids Camp and your child's name)
By submitting this registration, I give my child, whose name is indicated above, permission to participate in Trinity Baptist Church's 2023 Kids Camp.