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Bible Impact Ministries; Reaching Tomorrow’s Leaders, Today!

Your Information

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Last, First, Middle
(123)123-1234

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In Case of Emergency

Camper's relationship to the Emergency Contact
(123)123-1234

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RETREATS

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SUMMER CAMPS

Check only ONE, Call us at 573-265-7445 for more information.
Please specify
Please specify.

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PARENT/ GUARDIAN AGREEMENT

By my Electronic Signature, I GIVE PERMISSION for Whispering Winds Bible Camp (WWBC) to secure medical treatment for the camper in case of illness or accident. I GIVE PERMISSION for my child to participate in all Summer Camp activities, both on and off camp property, either by walking or riding in camp vehicles, including (without limitation): hiking, backpacking, canoeing, kayaking, caving, water tubing, low ropes course, climbing wall and swimming. I ACKNOWLEDGE AND ACCEPT the risks involved in camping activities. I ACCEPT personal financial responsibility for any bodily injury sustained while my child is at WWBC. Furthermore, I PROMISE to hold harmless WWBC and its representatives for any injury related to Summer Camp. I GIVE PERMISSION for my child to attend Summer Camp and receive the Bible-based instruction provided. I GIVE PERMISSION to use pictures including the camper in organizational publicity.


    Signature (must have a parent's signature if under 18)

The must be done by the person filling out the form.
To verify that you are who you say you are, please give us the last four numbers of your Social Security Number (xx-xxx-1234)
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Bible Impact Ministries
Whispering Winds Bible Camp
599 Mound Ridge Road
Cook Station, MO 65449
Voice: 573-265-7445 FAX: 573-265-5052