Medical Release Permission Form and Release of Liability

In consideration for being accepted by Great Commission Church (GCC) to participate in the following event listed below, I do hereby release and forever discharge and agree to hold harmless GCC and the directors thereof from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and participant that occur while said person is participating in said trip and activities. The undersigned further agrees to hold harmless and indemnify said church, its directors, employees and agents for liability sustained by said participant, including expenses incurred attendant thereto. The undersigned further consents to administration of first aid and/or doctor's care, or any other form of medical treatment necessitated by illness or injury that may require the same.

Event

If you agree with the above statement type your full name below:

Parent or Guardians Full Name

CHILD INFO

List all Childrens full names and Date of Birth who are going to the event listed above

List up to 3 people your child would like to room with.

Please give a summary of your children's current spiritual conditions. (Salvation, what are they wrestling with /questioning, what conversations should we have with them, what do they need to know?)

INSURANCE & MEDICAL INFO

Insurance Company Name and Policy#

ID# and/or Group#

Insurance Company Phone Number

Child's known allergies (environmental AND medications, please):

Child's known medical conditions/issues that we need to be aware of:

Are there any other special circumstances or physical limitations that we need to be aware of?

PARENT INFO:

First Name

Email Address

Last Name

Mobile Number

EMERGENCY CONTACT INFO

In Case of Emergency, Notify:

Relationship

Best Contact #

If parent or emergency contact can't be reached:

In the event I am unable to be reached, I also grant the GCC staff & chaperones the authority to make medical decisions for my child while he or she is in their care.

Please list the following: Childs Social Security numbers / Names and numbers for: Family Docter / Family Dentist

By signing below, as the parent/legal guardian of the child, I am registering for the event listed above. I hereby give Great Commission Church Staff and/or chaperones permission to secure medical treatment for my child.

Signature of Parent or Guardian

POLICIES, GUILDELINES AND CAMP RULES

Please note: If a rule is broken, a camper will be sent home at the parent's / guardians' expense.

POLICIES, GUILDELINES AND CAMP RULES

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Camper Guideline Summary & What to Pack

Here are general guidelines and packing lists for most of the camps we offer.

If a rule is broken, a camper will be sent home at the parent's / guardian's expense, no refund will be offered. In some situations, a warning will be given to the camper.

CAMP RULES:

Cell-Phone Policy— We do NOT allow campers to bring cell phones to camp. Adult leaders will have their phones, so in case of an emergency, please contact JC Russell (901-623-4296). Campers found with a phone will be sent home.
Modest clothing. No short shorts, short skirts, halter tops, crop tops, or revealing swimwear. Guys must always wear a shirt unless in your cabin or swimming. As a first warning, a student will be asked to change clothing by a same-sex leader.
Lights out - Leaving their cabin after lights out is prohibited and will result in immediate camp dismissal.
Free time - During free time, the campers will be required to stay within a camp boundary.
PDA - No romantic physical contact (Hand-holding, kissing, etc)
Electronics - No electronics
Food - NO OUTSIDE FOOD OR SNACKS (There are snacks for purchase there) NO FOOD OR DRINKS allowed in the Dorms or Recreation Hall.
Possessing alcoholic beverages, illegal drugs, vapes or tobacco will result in immediate camp dismissal.
Room switching is not allowed; please do not ask. You can make room assignment requests at registration.
Any items that may be seen as distracting by the leaders will be taken up and returned at the end of camp.

AT / BEFORE CHECK-IN

Make sure you have paid any outstanding balances
Make sure you have signed the liability and medical release forms
Turn in your cell phone to your guardian or church office. Phones will be stored in a locked drawer until returning from camp.
Review camp rules with students.
Check-in medication with proper dosage clearly marked.

WHAT TO PACK:

Clothing: Please bring enough to last the entire camp.
1. Shorts (not too short or revealing)
2. T-shirts (avoid ones with crude or rude imprinting please)
3. Swimwear (modest; two-piece swimsuits must be accompanied by a T-shirt)
4. Shoes-bring an extra pair of comfortable (tennis) shoes in case the pair gets wet.
Other:
1. Bible & pen
2. Towels
3. Bedding for twin-sized bunk bed (sleeping bag or sheets) & pillow.
4. Flashlight
Necessities like toothbrush, toothpaste, shampoo, soap, etc.
Cash for snack shop
Optional:
1. Camera
2. Insect repellent

PLEASE DO NOT BRING:

Electronic equipment such as walkie talkies, speakers, laptops, cell phones, radios, smartwatches, etc.
Alcoholic beverages, vapes, cigarettes or chewing tobacco, illegal drugs, etc.
Knives, rifles, bows and arrows, weapons, etc.
Jewelry or other expensive items, etc.

OTHER HELPFUL INFORMATION:

Medication: All medications (prescription and over the counter) must be in original packaging/bottle that identifies the prescribing physician, name of medication, dosage, and frequency of administration. No exceptions.

Signature of Parent or Guardian