Pursuing Christ, Together

Summer Schedule (May 26 – July 28):

Sunday Mornings

9:15am, No Summer Programing

10:30am, Family Worship
(elementary-age children join us in the sanctuary for worship;
birth-preK childcare provided)

Camp Counselor & Junior Counselor Release

Please enable JavaScript in your browser to complete this form.

Counselor's Name

First

Last

Name of Parent/Guardian #1

First

Last

Phone Number of Parent/Guardian #1

Name of Parent/Guardian #2

First

Last

Phone Number of Parent/Guardian #2

Pediatrician's Info/Camp Agreement

Pediatrician's Name

First

Last

Pediatrician's Phone Number

Pediatrician's After-Hours Phone Number

Camp Agreement

I recognize that camp involves outdoor activities and that an injury to my child may be sustained. The child listed on this form has my permission to attend the CCC Camp they have been assigned to as a counselor or junior counselor. In the event that medical treatment is necessary, every effort will be made to contact me. If I cannot be reached, I give permission to camp staff to secure the services of a licensed physician to provide the care necessary for my child's well-being and agree to pay the charges for such.

Acknowledge

I agree with these terms

Christ Community Church exists to reflect the redeeming grace and transforming truth of Jesus Christ in a college town.

503 South High Street
Bloomington, Indiana 47401 (directions)
Phone: (812) 332-0502
Email: info@cccbloomington.org
Subscribe to receive a weekly email update