Online Registration Form
Camp
Grade Completed:

Name:

Address:





Phone:

Birthdate:

Age:

Gender:

Email:

Father/Guardian:
Phone #

Mother/Guardian:
Phone #

Emergency Contact:
Phone #

Do you attend a Church?

If Yes, which one?




Participate Information
Name of Physician:

Phone Number:


Health Information
Are there any health issues/concerns our staff should be aware of?

If yes, please explain:









Are there any physical, psychiatric, behavioral, emotional or
developmental concerns our staff should be aware of?

If yes, please explain:









Medication of any kind will not be administered by the staff.
Camp PhisherKidz staff are authorized to release my child to the individuals listed below.  I understand that each authorized person must be at least sixteen (16) years old, and that my child will NOT be permitted to leave the camp with anyone not listed below.  All authorized individuals may be required to show identification.  In the event you need someone not listed to pick up your child, please send a note or call the Church office to make arrangements.  My child may be released to the following individuals (include yourself):
You will be charged $5.00 if you do not pick up your child by 5:15 p.m.  In addition to this fee, for every five minutes you are late, you will be assessed an additional fee of $1.00.  Payment is due upon pick up the participant.  Thank you for your cooperation.
Pick-up Policy
Late Pick-up Fee Policy
Activity Program/Field Trip Liability Release/Authorization
I hereby represent and warrant that I am the guardian of                                          and am authorized to provide the releases, authorizations and permissions as stated below and all information above is accurate and complete.  I hereby give permission for
to participate in all program activities, including field trips in approved vehicles and agree to release First Baptist Church of San Marcos, Texas, its agents, officers, employees, and servants from all liability arising from any harm or injury incurred by the participation of my child in Camp PhisherKidz.  Unless otherwise indicated by a parent/guardian in writing at the time of registration, photographs of participants for use of promoting Camp PhisherKidz may be taken while participating in the program activities.  No personal information other than the participant's first name will be released under any circumstances except as required by law.  By way of copy of this form, I authorize the staff of Camp PhisherKidz and First Baptist Church of San Marcos, Texas, to obtain medical/hospital treatment for the above participant in the event of an emergency.
Your name serves as your signature on this online form.
Date
Name                                                Phone Number  Relationship to Camper
1.

2.

3.

4.
Camp Phisherkidz is open to all children who have COMPLETED Kindergarten through 6th grade.

Space is limited so register early!

Dates:
Monday, July 14 through Thursday, July 17.

Time:
8:30 am -4:30 pm. 
Early Drop off:  8:00
Late pick up:  5:15 pm.



You are not registered until fees are paid. 

Please remit payment to:

First Baptist Church
325 W. McCarty Lane
San Marcos, TX 78666
Attention: Camp PhisherKidz

Please include campers name on memo line of check!

T-shirt Size:
Children's sizes:
XS =  2-4
S = 6-8
M = 10-12
L= 14-16

Adult S is same size as Children's L, just alittle longer.

Adult sizes:
S = 6-8
M = 10-12
L = 14-16
XL = 18-20
XXL = 22-24
Online Registration is CLOSED! 
You may register at First Baptist Church Monday, July 14.