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A Preteen Camp in Texas Sponsored by Tryon Evergreen Baptist Association
4 day, 3 night Fun Camp for 3rd through 6th Graders

CBC PreTeen Camp is July 21-24.

Camp Location:

Carolina Creek Christian Camps, 84 Wimberly Lane, Huntsville, TX 77320

For additional information, please contact Chester Holloway, Children’s Pastor at 281-593-1751

Deposit of $50.00 due May 19th.

Remaining balance due July 7th.

Register your camper below…

Camper's Name *
Camper's Name
Camper is... *
Date of Birth
Date of Birth
Parent's Name *
Parent's Name
Address *
Address
T-Shirt Size *
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Does the camper currently have any of the following? *
Date of last Tetanus Shot *
Date of last Tetanus Shot
I give permission for my camper to receive age appropriate over the counter medication. *
Cost of PreTeen Camp *
Participation Agreement *
I have listed above my or my child’s physical conditions or medical problems that may need attention and all medications regularly used by myself or said minor. I understand failure to disclose medical information and/or condition may result in dismissal from Kids Life Kamp (TEBA)/Carolina Creek Christian Camp. In case of the illness of myself or my child, Kids Life Kamp (TEBA)/Carolina Creek Christian Camp will try to notify whoever is listed as the emergency contact person. In the event there arises a medical emergency concerning myself or my child, at a time where the emergency contact cannot be notified, I authorize Kids Life Kamp (TEBA)/Carolina Creek Christian Camp to consent to any necessary X-ray examination, anesthetic, medical or surgical diagnosis or treatment, or hospital care. I hereby consent and give my permission to the Kids Life Kamp (TEBA)/Carolina Creek Christian Camp staff or any attending physician to make such decisions and to perform such medical treatments and/or surgery upon myself or my child that may, in their sole discretion, be necessary and proper under the circumstances. I DO RELEASE, ACQUIT, DISCHARGE, AND COVENANT TO HOLD HARMLESS KIDS LIFE KAMP (TEBA)/CAROLINA CREEK CHRISTIAN CAMP STAFF, PERSONNEL, OR ANY OF ITS REPRESENTATIVES FROM ANY ACTIONS, DAMAGES, OR LIABILITIES ARISING OUT OF ANY INJURIES OR PROPERTY DAMAGE SUSTAINED DURING THE PARTICIPATION IN THE CAMP AND/OR RESULTING FROM THE TREATMENT OF ANY ILLNESS, SICKNESS, OR ACCIDENT, INCURRED BY MYSELF OR MY CHILD DURING HIS/HER STAY AT CAROLINA CREEK CHRISTIAN CAMP, EVEN IF SUCH INJURIES OR DAMAGES ARE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE (BUT NOT GROSS NEGLIGENCE OR RECKLESSNESS) OF KIDS LIFE KAMP/CAROLINA CREEK CHRISTIAN CAMP, ITS OFFICERS, AGENTS, EMPLOYEES OR PARTICIPANTS. In consideration for being permitted to attend Kids Life Kamp (TEBA)/Carolina Creek Christian Camp and participate in the activities conducted by the Camp, I, on behalf of myself, my child, my legal representatives, heirs and assigns, do hereby release, waive, and forever discharge Kids Life Kamp (TEBA)/Carolina Creek Christian Camp and its officers, employees, volunteers, and agents, of and from any and all loss,damage, claim, demand, action or right of action, of whatever kind or nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown, death or property damage resulting or to result from any accident that may occur as a result of my or my child’s participation in the camp activities or any activities in connection with the Kids Life Kamp (TEBA)/Carolina Creek Christian Camp, whether or caused in whole or in part by the negligence (but not gross negligence or recklessness) of Kids Life Kamp (TEBA) /Carolina Creek Christian Camp, its officers, agents, employees or participants. I, personally, and on behalf of my child (if child is the camp participant), hereby give Kids Life Kamp (TEBA)/Carolina Creek Christian Camp permission to use my and/or my child’s name, photograph, quotations and likeness in any advertisements or promotions performed in connection with the camp and agree that neither I nor my child shall be entitled to any compensation for such use.I agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Texas, and that if any portion of this agreement is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect.Kids Life Kamp (TEBA)/Carolina Creek Christian Camp is authorized to provide or obtain medical care for me or the child, as it deems appropriate, and to exchange medical information with third party care givers.To the extent a claim asserted against a Released Party by a camper or other visitor or Parent shall be brought exclusively in Walker County, Texas, and the laws applicable thereto shall be those of the State of Texas, not including those laws which may apply the laws of another jurisdiction.This Agreement may be amended only by a written instrument, signed by the parties hereto. This Agreement is intended to be binding upon my, and the child’s, heirs, estates, executors, guardians, administrators, legal representatives and assigns.
Digital Signature *
Digital Signature
By typing your name below, you affirm that you have completed the online registration, have read the participation agreement and are the responsible parent for the camper above.