MVF SUMMER CAMP REGISTRATION

Mountain View Fellowship

271 N 600

Heber City, UT 84032

www.mvfchurch.com

Participant Information

First Name

Last Name

Gender

Birth Date +

Grade *

High School, June 18th - June 22nd (Cost: $300)

Junior High, June 22nd - June 25th (Cost: $250)

Student Phone Number

Email Address

Household / Adult Primary Contact

Relationship to Participant: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Alternate Phone

Email Address *

Medical Information

List any handicaps or medical problems:

Any allergies or reaction to medications? If so, please list them.

Present medications?

Parent/Guardian Signature

Payment Method (High School $300) & (Junior High $250) *

Online (http://mvfchurch.com/give)

Text (Text 84321 with $amount youthcamp)

In person (Cash or check made payable to MVF Church)

Emergency Medical Release
I hereby give consent to any emergency medical treatment deemed necessary by Big Canyon Ranch and MVF Church ministers, leaders, employees, volunteers, or agents of MVF Church during the above-mentioned student's involvement at this event. I recognize that when my child attends this event, he/she will be exposed to the physical risks involved in activities related to this event.
Release of Liability
By signing this form, I expressly warrant that my child is capable of withstanding both the physical and mental demands of the activities involved. I also expressly assume all risks of the child participating in the activities, whether such risks are known or unknown to me at this time. I further agree to indemnify and hold harmless Big Canyon Ranch and MVF Church ministers, leaders, employees, volunteers, or agents from any and all claims arising from my child’s participation in it’s activities and programs, or as a result of injury or illness of my child during such activities, or as a result of transportation to and from or lodging associated with the activity.
Photo Release
I hereby give permission for MVF Church to use any photo or video taken at this event. I release my right to any kind of remuneration for said photos or videos. *

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