J.A.M. CampJesus and Me Sports Camp

June 15—19, 20159:00 a.m - 4:00 p.m.

For children 7-12 years old(as of 8/31/15)

Hephzibah Baptist C

hurch1794 W

endell Blvd. W

endell, NC

27591

Join us so your kids will KNOW God’s sovereignty, EXPLORE the New Testament, and SERVE God in practical ways.

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

Go

d’s Grace

Pa u l ’ s R a c

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J.A.M. CampJune 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

J.A.M. Camp Registration FormLast 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

2 Softball 1 BaseballMorning Sports 1

___ Basketball___ Football (boys)___ Cross Country___ Soccer

___ Softball (girls)___ Gymnastics___ Kickball___ Swimming

___ Baseball (boys)___ Dance (girls)___ Soccer

___ Volleyball (girls)___ Disc Games___ Kickball

___ Athletic Performance Training

Afternoon Sports 2

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 NoIf 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:

Do NOT write in this box — HBC Staff OnlyPayment information:

q $80.00 Paid in Full q $90.00 (Paid after 5/30/2015) q Cash q Check