Immersion School

Registration Information

Parent Name*

Student Name*

Address*

Email*

Phone Number*

Student Age*

T-Shirt Size*

Medical Release Information

Emergency Contact*

Phone Number*

Insurance Company*

Policy Number*

Allergies*

Special Dietary Needs/Restrictions*

Terms & Agreements

Terms & Agreements*

I give permission for my child to attend the 2017 Immersion School with Calvary Monterey, July 25-28, and to participate in all activities with the event. I give permission for medical attention to be given to my child in case of injury, including major surgery. I understand that I will be contacted as soon as possible in case of such an incident. I request that youth staff carry out any discipline: if necessary, I will pay the expense of my child being sent home any time during the trip at the request of the youth staff.

I have read and agree to the terms above.

Almost done, where should we send the confirmation?

Name*

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