2021 AB Summer Camp Registration


Format (MM/DD/YYY)
Click or drag a file to this area to upload.

Champ Shirt Information:

Please check your size

* 1st camp shirt is included in your activity fee and each additional shirt is $10.00

Parent/Guardian Information:



Emergency Contact Information

Authorized Pick-Up Information


Terms of Agreement

Medical Release Information


I give permission for the camp staff or emergency care personnel to administer first aid or medical treatment in the event of an emergency involving my child.

Water Release:

I hereby give my child permission to participate in water base activities on field trips and at Camp AB.

Photo Release:

I hereby give permission for my child to be photographed during the Camp AB Summer Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Camp AB Summer Camp and its affiliates.

Kid’s Hope Alliance Consent


I give consent for my son/daughter’s school records, and afterschool/camp applications to be accessed by Kids Hope Alliance staff for the purpose of monitoring and gathering data for the analysis of program effectiveness.

I hereby give my child permission to participate in the Abyssinia Baptist Church Summer Camp Program. I understand that the Abyssinia Baptist Church is not responsible for any accidents or injuries unless there is negligence on their part.


In consideration for the privilege of allowing my child to participate in the above-named activity, I agree to release and hold harmless the Church, its officers, and agents, from any liability to or responsibility for bodily injury, damage or illness to the above-identified child while participating in any youth athletic or social activity which may be directly or indirectly sponsored by the Church. Further, I agree to indemnify and hold harmless the Church, its officers and agents with respect to any claim asserted by or on behalf of my child as a result of bodily injury, illness, or damage.

Type Full Name

Camp Fees

Please select the weeks your camper will be attending Summer Camp.

*Campership covers all 8 weeks

PARENT’S AGREEMENT:


There is a $80.00 non-refundable deposit to secure a spot for your child at Camp AB which does go towards your camp balance. Please review the payment schedule for the cost of each week for day camp and extended hours. In the event of cancellation, your deposit will not be refunded. If child misses a day or more during the week, there is no deduction of fees. I also acknowledge payment is due Thursday before the next week. Payments accepted in cash, credit cards or certified money order (NO CHECKS)

Type Full Name

ENTER CAMPER’S INFORMATION


CAMP SHIRT INFORMATION

Select shirt size from Youth or Adult sizes below.


PARENT CONTACT INFORMATION


TERMS OF AGREEMENT

Please read and accept each section of the Terms of Agreement


Photo Release:
I hereby give permission for my child to be photographed during the Camp AB Summer Camp. I understand the photos will be used to keep a journal of activities, share during PowerPoint presentations and/or reports to our donors, and for promotional purposes including flyers, brochures, newspapers, and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Camp AB Summer Camp and its affiliates.


Kid’s Hope Alliance Consent: (Please check if your child is under the campership only):
I give consent for my son/daughter’s school records, and afterschool/camp applications to be accessed by Kids Hope Alliance staff for the purpose of monitoring and gathering data for the analysis of program effectiveness.


Summer Camp Release:
I hereby give my child permission to participate in the Abyssinia Baptist Church Virtual Summer Camp Program. I understand that the Abyssinia Baptist Church is not responsible for any accidents or injuries unless there is negligence on their part.
In consideration for the privilege of allowing my child to participate in the above-named activity, I agree to release and hold harmless the Church, its officers, and agents, from any liability to or responsibility for bodily injury, damage or illness to the above-identified child while participating in any youth athletic, virtual or social activities which may be directly or indirectly sponsored by the Church. Further, I agree to indemnify and hold harmless the Church, its officers, and agents with respect to any claim asserted by or on behalf of my child as a result of bodily injury, illness, or damage.

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