High School Winter Weekend Camp 2021

Please fill out this form and click submit.
Thank you parents for registering your student camper for our High School week. It is going to be a transformative weekend!

The dates are from Friday, January 7 - Sunday, January 9
We have registered for 10 girl and 10 boy spots

You have two parts that you need to complete:
Registration: Using the link in the eNews
Payment: Pay through First Pres Breeze (this form)

Carpools are available and will be coordinated by a parent closer to the start of camp.
Parent/Guardian Information

 
 
 
 
 
 
 
 
 
 
Student #1 Information

 
Please select one option.
 
 
 
 
 
 
 
 
Student #2 Information

 
Please select one option.
 
 
 
 
 
 
 
 
Student #3 Information

 
Please select one option.
 
 
 
 
 
 
 
Parental Authorization

I hereby authorize my child(s) named above, to participate in all activities under the Church auspices whether within the confines of the Church building and grounds or on organized trips away from the Church premises. In the event any illness or accident should befall my child while participating in these activities, I hereby request and authorize any adult conducting such activity for the Church to secure emergency medical treatment at any hospital or by any qualified medical personnel for said child and agree to pay for same.


I further release the said First Presbyterian Church San Mateo and its representatives, including both volunteer and professional personnel, from any claim for damage of any kind that may befall said child and agree to hold them harmless from same.


I recognize that some Church activities will require that volunteer drivers transport passengers to and from Church-sponsored events. Passengers, who ride with volunteer drivers, and parents or guardians of the passengers, must assume the risk that an accident may occur. In no event will the Church be held responsible. I understand that I am waiving for myself and my child all claims against First Presbyterian Church San Mateo and its staff members, employees and volunteers for injury, accident, illness, or death occurring during or by reason of any Church-sponsored trip or activity.


In addition, participants may be photographed during FPCSM activities. These photos may be used anonymously for promoting or sharing activities in printed materials, electronically on the church website, and/or on social media.
 
*By entering my name in the box above, I am providing my digital signature on this form
Payment

For PayPal Credit or Debit please select the number of students you are registering from the dropdown menu, or select Pay by Cash/Check (do NOT enter an amount) to pay cash or check to FPCSM.

Credit/Debit
High School Price for Camp: $205
Deposit for HS: $50



Cash/Check
High School Price for Camp: $205
Deposit for HS: $50

You may choose to pay the full amount at a later time or at the time of registration.


Contact John Garcia for scholarship information
 

Description

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