Bethel Pentecostal Church - Kingdom Quest 2026

1. Participant's Information

Child's First Name

Child's Last Name

Gender

Birthdate

Allergies/ Medical Concerns

2. Parent/Guardian & Emergency Contact

First Name(s)

Last Name(s)

Primary Phone Number

Email

Emergency Contact (if parent(s) unreachable)

Phone Number

Relationship

Participation and Liability Release

1. Risk Acknowledgment: I am aware that camp activities (e.g., sports, games, crafts, snacks) involve inherent risks of injury. I voluntarily allow the child(ren) listed above to participate despite these risks.

Acknowledged

2. Liability Waiver: I release Bethel Pentecostal Church, its staff, and volunteers from any and all liability for personal injury, accident, or property damage sustained during the camp.

Acknowledged

Media/Photo Release: I give permission for Bethel Pentecostal Church to use photos or videos of my child for promotional purposes (e.g., website, social media, brochures).

Yes

No

Signature

Relationship to Child

1. Participant's Information

2. Parent/Guardian & Emergency Contact

Participation and Liability Release

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