Trees of Righteousness (TOR) Summer Program Registration

Turning Point Ministries Church, 7245 East Lawn Drive, 45236, 513-731-7245

Student Information

Name:
Gender:
Address:
Birth Date:
Grade Entering in Fall:
Please Select Camp Week:

Program Cost:

Family of 1 child: $25.00 / week ; 3 weeks- $75.00

Family of 2 or more children: $50.00 / week ; 3 weeks- $150.00

Parent or Legal Guardian Information:

Parent or Guardian Name:
Relation:
Work Phone:
-
Cell Phone:
-
Home Phone:
-
Parent / Guardian 2 Name:
Relation 2:
Work Phone 2:
-
Cell Phone 2:
-

Emergency Contact Info

Emergency Contact Name (if parent or guardian is not available):
Emergency Phone:
-
Emergency Phone 2:
-

Email Confirmation

Parent E-mail (camper confirmation will be sent by email. if left blank, it will be mailed):
Additional E-mail:

Other Information

How did you hear about TOR Summer Program?
First Time Attending TOR?:

Health Information

Preferred Hospital:

In the event of an emergency, your child will be taken to the nearest hospital. Turning Point Ministries is not responsible for emergency and transportation costs. You will be notified immediately at the phone number provided.

Are immunizations up to date?
Date of last Tetanus Shot:
Any activity the TOR Participant should be restricted from:
Any physical, mental, or other condition that would require special attention or medication while at camp?
List all medications, both prescribed and over the counter. All medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.
List any allergies (bees, peanuts, dairy, etc):
Any dietary needs we should know about?

TOR Program Photo Release

Does the TOR program have permission to use photos of your child in educational or promotional material? (There is no cost)
Do you or a family member attend Turning Point Ministries Church?
If so, what is their name?
Does your child attend the church's "Children Church" program?:
If so, what is the child's name?

Payment Information

$25.00 per week ($75.00 for three weeks); Families with two or more children - $50.00  per week ($150.00 for three weeks); Program capacity - 50 students.

To guarantee a space, full payment is necessary.

Method of Payment:

If using a credit or debit card, payment can be made through PayPal located on the church website (www.tpmpc.org). 

Payment by cash - on site (10:00am - 12pm) every Saturday beginning May 20, 2017 - June 10, 2017

Be certain to enter your email address correctly on the registration form to receive confirmation via email within 1 week.

I understand that in order for my child to attend the TOR Summer program, a registration fee of at least one week ($25.00 for each individual child or $50.00 for a family with 2 or more children) must accompany this form. By hitting submit and putting your initials below, you agree that you are the parent or legal guardian of the above named camper(s), and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical treatment for the above named TOR participant by authorized personnel. The program carries liability insurance. I understand that the above named TOR participant will only be released to the names listed above.  An update may be done at registration. I certify that my child has my permission to attend camp and participate in all activities. We have limited space, therefore, payment of all three weeks guarantees a space for you.

ELECTRONIC SIGNATURE. PLEASE INITAL:

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