BCA Summer Camp Registration Form

Camper Information

Camper Name *

First

Middle

Last

Date of Birth *

Grade Level in 2025/2026 *

Name of Current School *

Medical Concerns *

Current Medications *

Parent/Guardian Information

Parent Name *

First

Last

Email *

Phone *

Address *

Address Line 1

City

State

Zip Code

Emergency Contact #1

Name *

First

Last

Phone *

Layout Name Parent/Guardian

Emergency Contact #2

Name *

First

Last

Phone *

Summer Camp Waiver and Release of Liability Form

I understand that my child is expected to behave respectfully and follow the rules of the camp. Disruptive behavior may result in dismissal from the camp with no refund.

I give permission for Barrington Christian Academy Summer Camp to photograph or record my child during camp activities and to use such media for promotional or educational purposes, including social media and the camp’s website.

In the event of a medical emergency, I authorize the camp staff to provide basic first aid to my child if necessary. I further authorize the staff to secure emergency medical treatment for my child and agree to be responsible for any resulting expenses.

By signing below, I, the undersigned parent or legal guardian of the above-named camper, grant permission for my child to participate in the Barrington Christian Academy Summer Camp. I acknowledge that participation in theater camp activities involves certain inherent risks, including but not limited to physical activity, stage equipment, and group interaction.

I hereby release and hold harmless Barrington Christian Academy, its directors, staff, volunteers, affiliates, and representatives from any and all claims, demands, damages, injuries, or losses that may arise from participation in camp activities, whether caused by negligence or otherwise.

Signature *

Clear Signature

By signing above I acknowledge that I have read and understand this waiver and agree to its terms.

For which summer camp is this registration?

Stripe Credit Card *