Camp 180 Information Request - North Coast Church

Camp 180 Information request 2025

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Camper Name*
First Last
Birthday
Gender*
School Year*
Medical Conditions
Dietary Requirements
Parent/Guardian Names*
Your Email*
Emergency Phone*
I hereby consent and agree for North Coast Youth to take photographs and video footage of my child/children and to use these in future Camp 180 promotion material and North Coast Youth social media.
I consent to the provision of first aid and the provision of analgesics in the case of my child/children requiring medical treatment or the in case of a medical emergency. I authorise North Coast Youth, where it is impracticable to communicate with me, to arrange for my child/children to receive such medical or surgical treatment or ambulance transport as may be deemed necessary. I undertake to pay any costs that may be incurred for the medical treatment, ambulance transportation and medications.