1. sports

Jesus and Me Sports Camp
Our studies include:
• Paul Becomes a Friend of Jesus
• A Jailer and His Family Join the
Race
• Paul Faces Trouble in Ephesus
• God Sends Paul’s Nephew to
Help
• God Saves Paul at Sea
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Join us so your kids will KNOW
God’s sovereignty, EXPLORE
the New Testament, and SERVE
God in practical ways.
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Hephzibah Baptist Church
1794 Wendell Blvd.
Wendell, NC 27591
J.A.M. Camp
June 15—19, 2015
9:00 a.m - 4:00 p.m.
For children 7-12 years old
(as of 8/31/15)
J.A.M. Camp Registration Form
J.A. M. Camp
June 15-19, 2015
9:00 AM - 4:00 PM
J.A.M. (Jesus and Me) Sports Camp is a camp
for children 7 years through 12 years old.
(as of 8-31-15)
The camp is designed so that children
can participate and grow in their athletic
ability during two sports times, while being
challenged with the Gospel of Jesus Christ
through worship and Bible study.
The cost of camp is $80.00 per child ($90.00
after May 30, 2015) and includes sports,
t-shirt, lunch, and Bible study materials.
Sign up early! The sports times fill up fast!
For more information, contact Leanne Lindsay
at Hephzibah Baptist Church
919-365-7847.
Return this form to the church office with the
payment or mail to:
HBC Wendell, 1794 Wendell Blvd.
Wendell, NC 27587
Last Name: First Name: Gender: Address: Zip: Age on 08/31/15: : Grade (2015-2016 School Year): DOB: Mother’s Name: Father’s Name: Home Phone: Cell Phone (Mother): (Father): E-Mail: Church Home: Shirt Size: q YS q YM q YM q YL q YXL q AS q AM q AL q AXL
Choose 2 afternoon and 2 morning sports in order of preference:
example: 1 Soccer
2 Disc Games
Morning Sports 1
___ Basketball
___ Football (boys)
___ Cross Country
___ Soccer
2 Softball
___ Softball (girls)
___ Gymnastics
___ Kickball
___ Swimming
1 Baseball
Afternoon Sports 2
___ Baseball (boys) ___ Volleyball (girls)
___ Dance (girls)
___ Disc Games
___ Soccer
___ Kickball
___ Athletic Performance Training
Player Information (allergies, health conditions, medications, etc.):
Please read carefully/Must be signed by parent or guardian:
Does this child have any disabilities, handicaps, present injuries, allergies, hemophilia, heart condition, and
other signifiant medal conditions?
q Yes
q No
If yes, please explain: Family Doctor: Phone: Emergency Authorization:
I, the undersigned, parent or legal guardian of the participant, a minor, hereby authorize the coaches,
counselors, or parents of campers acting in the capacity of activity supervisors/ vehicle drivers, as my agents to
consent medical treatment. In case of emergency I hereby authorize treatment and care at a hospital.
Parent/Guardian Signature: Date: Waiver of Liability and Disclaimer:
I, the parent, or guardian of the above named individual acknowledge that participation in athletic events
necessarily involve risk of physical injury. In consideration for accepting the registration of the above named
individual and permitting the voluntary participation of said individual in its programs I hereby release, and
hold harmless the JAM Sports Camp staff from any claims arising out of or relating to any physical injury that
may result to said individual while participating in the camp.
Parent/Guardian Signature: Date: Payment information:
q $80.00 Paid in Full
Do NOT write in this box ­— HBC Staff Only
q $90.00 (Paid after 5/30/2015)
q Cash
q Check