Adult Sponsor Registration

This form is for adult sponsor registrations only. If you are a parent of a child camper or a group leader wanting to register their group, please use one of the corresponding links below.

Group Leaders Child Campers

An image of four male adult sponsors sitting on a bench under the covered dodgeball barn.

Sponsor Details

Group Name * Select the group you are attending camp with. If you don't see your group, please contact your group leader.

First Name *

Last Name *

Birthday * MM-DD-YYYY

Shirt Size *

Gender *

Home Address *

City *

State *

Zip *

Medical Conditions

VERY IMPORTANT! — Texas state law requires that certain information be disclosed. Your cooperation as leaders and parents will aid in that. This form must have allergy and current immunization information listed with exact dates for anyone under 18. This may be an inconvenience but state law requires guests to be sent home immediately that do not give complete information.

Allergies Please list and explain any allergies in the field below.

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Medications

Medications Please list any medications and instructions in the field below.

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** Texas law requires that all prescription medications (meds) for children & youth be stored & dispensed only by the Camp Health Officer (CHO). For a further step of safety, TBE recommends that all youth & adult meds, prescription & non-prescription, be stored & dispensed only by the CHO. This recommendation will be at the discretion of the group leader and the CHO. Prescription meds shall be sent in the original container with prescription label and gathered in a clear ziploc-type bag with camper name & church clearly marked. Upon camper arrival, the CHO shall place meds and related paraphernalia in a lockable storage area not accessible to campers. Meds shall be administered only by the CHO, unless otherwise allowed. At no time shall a child or youth be allowed to carry or self-administer meds without adult supervision, except in the case of immediate-use meds needed for life-threatening conditions (i.e. bee-sting meds, inhaler, etc…) and limited medications approved for use in first-aid kits. In each of these cases, the camp shall have on file a written statement of medical necessity from the prescribing doctor or the written approval of the Camp Health Officer for any camper to carry medication and related paraphernalia or devices.

Emergency Details

Emergency Contact * First Name

Last Name Last Name

Phone Number *

Insurance Company

Name of Insured

Policy Number

Name of Doctor *

Phone Number *

Name of Dentist

Phone Number

Acknowledgements Please read the following statment in full before signing.

I understand that any youth or adult with a high fever will be sent home. I hereby authorize the camp health officer to administer medication to this child. If a medical emergency should arise while the above youth or adult is in attendance at TBE, I hereby authorize the camp health officer or camp director to provide care and/or transport them to a medical facility. I further authorize the medical facility to administer necessary care upon arrival. I do understand that camper insurance at TBE is secondary to personal insurance which should be used for any claims occurring at TBE. I acknowledge that I am signing by means of an electronically-produced signature, that shall have the same legal effect as if, such signature had been manually written and shall be deemed to have been signed by myself for the purposes of any statute or rule of law that requires. I acknowledge that, in any legal proceedings between myself and TBE in any way relating to this computer-based registration form, each party expressly waives any right to raise any defence or waiver of liability based upon the execution of this authorization by a party by means of an electronically- produced signature.

Emergency Authorization Signature * Please type your full name above. By typing your name you are accepting the acknowledgements outlined in the Acknowledgments field.

Adult Sponsor Registration

Sponsor Details

Medical Conditions

Medications

Emergency Details

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