Infinity Camp

CAMPER INFORMATION

Name(Required)

First Last

Campus:(Required)

Date of Birth(Required)

Age(Required)

Gender(Required)

Male

Female

School Grade(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

PARENT/GUARDIAN INFORMATION

Permission:
Give permission for my child to fully participate in Activity described above.

I/We give such permission with the full knowledge and permission that the agents are not necessarily licensed as care providers. Release:
Release Good Hope Christian Centre and its agents, elders, employees, volunteers, leaders, members, ministers, officers, trustees and minders ("Good Hope Christian Centre") from and against any and all actions, causes of action, claims, damages, demands, injuries, liabilities and/or losses resulting from my child's participation in the activity or consequences of my/our inability, required or not, or even if not permitted to be physically present, and waive any claim for compensation for the same.

I/We acknowledge that there are certain risks associated with participation in any activity or programme, including transportation, accidents, injuries, loss of personal items, emergency medical needs, or other occurrences to any child. I/We assume the risk associated with such activities on behalf of myself/ ourselves and our child releases Good Hope Christian Centre and its agents, elders, employees, volunteers, leaders, members, ministries, officers, trustees and minders from any liability for such.

Name of parent/guardian with whom child resides(Required)

First Last

Contact No. 1(Required)

Contact No. 2

MEDICAL INFORMATION

Doctor's Name

First Last

Doctor's Phone

Please list any health problems or limitations:

Medical Authorisation and Responsibility:
1. Authorize an adult representative of Good Hope Christian Centre to request and sign for emergency medical services and treatment that my child may need as a result of, or while participating in the Activity.
2. Assume responsibility for payment of all bills for all medical services and treatment for my child, including transportation to and from medical facilities and to and from home.

Health Insurance/Medical-Aid:
1. I understand that Good Hope Christian Centre does not furnish any insurance for the Activity or any participant therein.
2. Advise that my child is covered under the following Health Insurance / Medical-Aid plan / policy:

Provider(s) Name:

Member I.D.:

Member(s) Name:

Option:

Beneficiaries Number:

Providers Phone Number:

Allergies

Food

Insect Bites

Plants

Medication/Drugs

Other

If you selected any of the above, please explain:

Will your child be bringing any medication to camp?(Required)

Yes

If yes, please specify:

Does your child know how to swim?(Required)

Yes

Dispute Resolution Agreement:
I agree that any civil action, claim or dispute arising from or related to allegations by or against Good Hope Christian Center, its agents, elders, employees, volunteers, leaders, members, ministries, officers, trustees, minders, shall be submitted to Biblically based mediation.

20th – 22nd February 2026

Register your kid(s) today!

CAMPER INFORMATION

PARENT/GUARDIAN INFORMATION

MEDICAL INFORMATION