Camper's name
Choose your camper’s current grade level. Backyard Bible Camp is for ages Preschool (4) through High School.
Parent/Guardian Name
Permission & Agreement
I acknowledge and understand that this PARENTAL AUTHORIZATION, CONSENT AND RELEASE has the same force and effect regardless of whether the activities engaged in are free or if a fee is charged. Further, I personally assume, on my child’s behalf, all risk in connection with said activities for any harm, injury or damages that may befall my child as a result of my child’s participation in the activities, whether foreseen or unforeseen, and I still wish to allow my child to proceed with the activities.

In consideration of my child being allowed to participate in these activities and to use Refuge Baptist Church, equipment and facilities, on behalf of my child, I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Refuge Baptist Church and its staff and volunteers, from any and all claims, demands, or causes of action, which are in any way connected with my child’s participation in these activities or use of Refuge Baptist church, equipment and facilities.

I understand that it is my obligation to inform the church of any and all health considerations or medical conditions that would restrict my child’s participation in any and all activities while in the care of Refuge Baptist Church. Should the need for medical attention arise the church will attempt to contact me as soon as practicable under the circumstances.
In cases of emergency, I further consent to the examination or treatment of my child by a physician duly licensed to practice medicine in the United States of America or any health care professional duly licensed to provide health care serviced in the United States of America for medical care and services deemed necessary by the doctor, its agents, servants, and employees. I give permission to the doctor or health care professional to provide any and all medical care they deem, in their professional opinion, to be necessary. I agree to pay for any and all medical expenses incurred as a result of the use of this consent.

I acknowledge by submitting this document, that if anyone is hurt or property is damaged during my child’s participation in these activities, I may be found by a court of law to have waived my right to maintain a lawsuit against the church on the basis of any claim form which I have released them herein. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions remain in full force and effect. I have fully informed myself to the contents of this PARENTAL AUTHORIZATION, CONSENT AND RELEASE by reading it before I signed it.
Photo Release
Refuge Baptist has a website, Facebook, and Instagram where photos and videos from our events are periodically published. We also have a bulletin board where we sometimes post photos from events. It is Refuge’s policy that photos of children are never published with names or other identifying information.
How did you hear about the Backyard Bible Camp?