Camp Rooted 25

July 31 - Aug 3 | See details here:
https://memorialchurch.net/camp-rooted/

CONTACT
Tisha Spencer: 573-230-7795

Name

This address will receive a confirmation email

Phone

Grade completed

Please select all that apply.

6 7 8 9 10 11 12

Shirt Size

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Small Medium Large XL XXL

I understand my child may be swimming in a pool and in the Lake of the Ozarks and I give permission for them to be on the water slide, blob, canoes, etc. at the camp.

Please select one option.

I agree I do not agree

I understand my child may be doing the high ropes course at their own risk. There will be a certified ropes camp leader there at all times.

Please select one option.

I agree I do not agree

I understand that while precautions will be made for COVID 19 and other illnesses, my child may be exposed to illness and that is a risk I accept. Temp checks will be done before leaving and each return to camp if a student leaves.

Please select one option.

I agree I do not agree

Waiver: I release Memorial Baptist Church and Encounter Cove and volunteers from any injury that my child sustains while at Camp Rooted located at Encounter Cove in Roach, Missouri. I understand that I am responsible for any medical care required in the event of injury. This shall serve as my legal signature.

Please select all that apply.

I Agree

Parent Name

Parent Phone

Payment: You may pay by cash or check to the church office M-Th 9-1 or Sunday mornings

Pay Online ($100.00) Pay by cash or check ($0) Request a scholarship ($0)

Amount

For office use only

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 31 - Aug 3

See details here:
https://memorialchurch.net/camp-rooted/

CONTACT
Tisha Spencer: 573-230-7795

Camp Rooted 25

Description

Please Fix the Following