IMPORTANT: If under the age of 18, a parent or legal guardian is required to complete and submit this registration form.
There are 3 payment options:
1. Pay $120 full registration now. Registration includes a $25 non-refundable deposit.
2. Pay only the $25 non-refundable deposit at this time. Space is limited, using this option will reserve your campers spot on the trip. Payment of the remaing balance will be due before the group leaves for camp. Payment of the balance must be paid in person by cash or check.
3. Pay in person at a later time. Due to space limitations, using this option will not reserve your campers spot until at least the $25 non-refundable deposit is made. All payment using this option must be made in person via cash or check.
Making payment at the time of submitting this form is a secure payment through PayPal. A PayPal account is not required to in order to process your payment if using a credit or debit card.
If you have any questions regarding payment, contact (315) 769-9951.
Informed Consent and Acknowledgement
I hereby give my approval for my child’s participation in any and all activities prepared by Cross Current Ministries & New Testament Church during the selected camp. In exchange for the acceptance of said child’s registration by Cross Current Ministries & New Testament Church., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Cross Current Ministries, New Testament Church, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.
In case of injury to said child, I hereby waive all claims against Cross Current Ministries & New Testament Church, including all leaders, counselors, and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all camp activities, including sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Medical Release and Authorization
As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named camper. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Permission is also granted to the Cross Current Ministries & New Testament Church, including all leaders, counselors to provide the needed emergency treatment prior to the child’s admission to the medical facility.
Release authorized on the dates and/or duration of the registered season.
This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.