Kindness Camp 2026

Parent / Guardian Name

Parent / Guardian Email

This address will receive a confirmation email

Parent / Guardian Phone

Address

Name of Camper

Camper Birthday

Does your camper have any allergies?

Does your camper have any dietary restrictions?

Is there any other medical information relevant for your child? (Lingering injuries, mental health, recent surgeries, ongoing medical issues, etc.) *

Emergency Contact Information (name /phone) Please list multiple if applicable

Authorization to Administer Medication - if applicable please list the medication and dose

I give permission for the named individuals to pick up my child. I understand that if persons other than the parent/guardian(s) will be picking up my child, I will give written authorization to the camp. Children will not be released to individuals without permission from the parent/guardian. A family code word is required. Please list the name and relationship of of the person(s) who may pick up your child and share your family code word below.

Wavier: WAVIER FORM Waivers and Informed Consent: By signing this form, I, as parent/guardian, permit the staff of Kindness Camp to use pictures of my child(ren) as a program participant in promotional literature, videos, and the Downtown Church website. I understand my child(ren)’s name(s) will not be published. I, as parent/guardian of ______________________ (“Child”), hereby assume all risks and hazards incidental to the conduct of the activities at Kindness Camp and transportation to and from the activities. My Child is fit for the program(s) in which I have enrolled him/her. I HERELY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS RELEASEES FROM EVERY CLAIM AND ANY LIABILITY THAT I OR MY CHILD MAY ALLEGE AGAINST RELEASEES (including reasonable legal fees and costs) AS A DIRECT OR INDIRECT RESULT OF INJURY OR DEATH TO ME OR MY CHILD BECAUSE OF MY CHILD’S PARTICIPATION IN ANY KINDNESS CAMP PROGRAMS, WHETHER CAUSED BY THE NEGLIGENCE OF the RELEASEES OR OTHERS TO THE MAXIMUM EXTENT PERMITTED BY LAW. I PROMISE NOT TO SUE RELEASES ON MY BEHALF OR ON BEHALF OF MY CHILD REGARDING ANY CLAIM ARISING FROM OR RELATED TO MY CHILD’S PARTICIPATION IN ANY KINDNESS CAMP PROGRAM(S). I ACKNOWLEDGE THAT, BY SIGNING THIS DOCUMENT, I AM RELEASING KINDNESS CAMP, AND THEIR REPRESENTATIVES, AGENTS, EMPLOYEES, VOLUNTEERS, MEMBERS, SPONSORS, PROMOTERS, AND AFFILIATES (COLLECTIVELY “RELEASEES”) FROM LIABILITY, AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS SIGN UP AND RELEASE FORM IS A CONTRACT WITH LEGAL AND BINDING CONSEQUENCES AND IT APPLIES TO ALL ACTIVITIES IN WHICH MY CHILD ENGAGES DURING THE SUMMER CAMP, REGARDLESS OF WHETHER SUCH ACTIVITY IS A PART OF A FORMAL PROGRAM. I HAVE READ THIS RELEASE CAREFULLY BEFORE SIGNING. I UNDERSTAND WHAT THIS RELEASE MEANS AND WHAT I AM AGREEING TO BY SIGNING. I understand that no insurance coverage for participants in these activities is provided by the Kindness Camp. By selecting the box below you are agreeing to the waver for the child you are registering.

I accept the conditions of this wavier.

Full Payment for Kindness Camp for one child

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Kindness Camp 2026
June 22-25 from 8:30a-3:00p

**Please register each camper separately using this form so we can have accurate data on our super-kind campers**

Cost: $250 per Camper

Scholarships are available.

Kindness Camp 2026

Description

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