Please complete an individual form for each camper/leader attending.
Families pay the camper fee for up to two children only; additional children attend at no cost.
If you have more than 2 children from your family attending, select the cash payment option to bypass the fee after you have paid for the first 2.
Leaders do not pay the camper fee. Select the cash payment option to bypass the fee.
**Transaction fee of $1.80 included in payment.**
Medical/Liabilty Release - Terms and Conditions
1. Subject: Participant recognizes and expressly agrees that participating in any adventure, course, sport, or activity is inherently dangerous. Further, participant recognizes that certain safety precautions are followed, yet following these does not
guarantee nor does Blomingdale Baptist Church guarantee participant’s safety.
2. Waiver and Release from Liability: Participant understands that Bloomingdale Baptist Church assumes no responsibility for injuries or illnesses that participant may sustain, a.) as a result of participant’s physical condition, b.) resulting from
participant’s participation in the activity, c.) as a result of another participant’s or third person’s actions, or d.) as a result of participant’s use of facilities, field, and/or equipment in connection with this activity. The participant releases and agrees to hold harmless, defend and indemnify Bloomingdale Baptist Church and its directors, board members, staff,and supporters from and against any and all claims for personal injury (including loss of life) and all other losses or damagesthat the participant may suffer as a result of his or her participation and/or enrollment in Bloomingdale Church Camp activities.
3. Property Loss: Participant understands and agrees that Bloomingdale Baptst Church along with participating churches and Behlehem Association Church Camp are not responsible for personal property that is lost, damaged, or stolen in connection with this activity.
5. Binding Effect: The agreement shall be binding upon participant, his or her heirs, estate, successors, and legal representatives.
6. Acceptance: If any portions of this waiver and release are held to be invalid, participant agrees the remaining terms shall continue to be in full legal force and effect. Participant understands and agrees that this waiver and release is binding upon me and my heirs, estates, and legal representatives.
7. Photo Release: I grant Bloomingdale Baptist Church the absolute right to copyright, re-use, publish, and republish by any medium, including electronically, any photos of myself or my child or in which they may be included, that may be taken whileparticipating in activities.
I have read and voluntarily signed this Waiver and Release of Liability.
8.Medical Release: In the event that he/she is injured and requires the attention of a physician, while attending the activity of the church, we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is called for, which a physician and/or hospital personnel refuses to administer without our consent, we hereby authorize the Pastor or any official leader of the church, to give such consent for us if we cannot be reached by telephone at one of the numbers indicated below or in case of an emergency when there is no time or opportunity to make a telephone call. In the event it becomes necessary for someone to give consent for us, we agree to hold such a person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent so long as the treatment is administered by or under the supervision of a licensed physician.