What grade is your child going into? (K-5)
Do you have any allergies?
If you answered yes to allergies, please describe!
If you would like to be paired with a friend, please let us know who that is.
Medical Waiver
I, the undersigned parent/guardian of the above-named child(ren), permit my child(ren) to participate in all Rooted Kids Camp (RKC) activities.
In the event of illness or injury, I authorize Rooted staff and volunteers to secure appropriate medical treatment for my child, including first aid and, if necessary, emergency medical care. I understand that every reasonable effort will be made to contact me before treatment beyond basic first aid (band-aids, ice packs, etc.). I accept responsibility for any medical expenses incurred. I release and hold harmless Five Points Community Church, its staff, and volunteers from liability for any injury or illness that may occur. Add any medical notes below that we need to know.
Media Permission
I permit my child to be photographed and/or videotaped during RKC activities. I understand that these images and recordings may be used in church publications, websites, social media, and promotional materials. I waive any rights to compensation or ownership of such media. Add any other information that we need to know concerning media permission.
Submit A copy of your responses will be sent to your email address.
