2018 EPIC Middle School Camp - HS Helper
EPIC | July 30-August 3 | 9am-1pm

COST: $10 per HS Helper.

STEP 1: Please complete one registration form per HS Helper.

YOUTH INFO
**used for communication and confirmation emails - check for typos**


ADDRESS


PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


YOUTH MEDICAL INFO
leave blank if none


EMERGENCY INFO


*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given EPIC is accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

 

Due upon registration.


When this form is processed, you will receive a confirmation email with payment instructions. Thank you!