Single Camper - Memorial Day Week Camp, Tuesday May 27 - May 30, 2025
Single Camper - Memorial Day Week Camp, Tuesday May 27 - May 30, 2025
MULTIPLE CAMPERS - Memorial Day Week
$65
Multiple Campers - Memorial Day Week Camp, Tuesday May 27 - May 30, 2025
Multiple Campers - Memorial Day Week Camp, Tuesday May 27 - May 30, 2025
Add a donation for St Pauls Episcopal Church
$
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Your information
United States
Indiana
Questions
Camper's Name (if signing up multiple campers, please list all names, from oldest to youngest)*
School Attending 24/25 School Year (list in order of oldest to youngest campers)
Grade(s) for 24/25 School Year*
Pre Kindergarten (>4 years old)
Kindergarten
1st
2nd
3rd
4th
5th
6th
I hereby grant St. Paul’s Episcopal Church (Indianapolis, Indiana) permission to use my child(ren)'s likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of St Paul’s Episcopal Church and will not be returned. I hereby irrevocably authorize St. Paul’s Episcopal Church to edit, alter, copy, exhibit, publish or distribute this photo or video for purposes of publicizing the St. Paul’s program or for any other lawful purpose.
In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video. I hereby hold harmless and release and forever discharge St. Paul’s Episcopal Church from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.*
Yes, I approve.
No, I do not approve.
Person(s) and relationship to child(ren) of who can pick up your child(ren):*
EMERGENCY CONTACT: First & Last Name, phone number and relationship to the child*
AUTHORIZATION AND WAIVER OF RISK By checking this box, I hereby agree and consent to my child participating in St. Paul's Day Camp. I acknowledge that, despite careful and proper preparation, there is still a risk of injury when participating in any activity. I release and hold harmless St. Paul's Episcopal Church and its employees, chaperones and volunteers, as well as any and all other participating organizations, their officers, agents, representatives, employees, and volunteers from any and all responsibility and liability for any injury, claim, costs, or any other damages whatsoever which may result from my Child's participation in the Camp. I further agree to assume full responsibility for the action of my Child as well as for the payment of any and all debts incurred by my Child during his/her visit and participation in the Camp.*
AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT By checking this box, I agree and consent to my child receiving emergency medical treatment in my absence should the need for such treatment arise during my Child's participation in the St. Paul's Day Camp. Should the need for emergency medical treatment arise, the following health information in the next question is voluntarily disclosed.*
Special Dietary Needs; Medications; Allergies. If none, please answer N/A**