VIP Camper-Singer Registration Form

For all youth singers who are attending Voices In Praise Youth Choir Camp!

Choir Directors, if you're interested in registering your ensemble, please view this page

or contact Holly Reynolds Lee (HollyRLee@gmail.com; 301-728-1748) for more info.

Full Name (First and Last) *

Nickname

Date of Birth *

Grade You're Entering

Your School

Student's Home Phone

Student's Cell Phone

Voice Part * 🛈

Tshirt Size * 🛈

Student's Email Address

Student's Home Address *

Address Line 2

City *

State *

Zip Code *

If you're coming with a church youth choir, please write the church name here:

Parent & Emergency Contact Info

Parent/Guardian Name (First and Last) *

Parent Cell Phone

Parent Email Address *

Parent/Guardian Name (First and Last)

Parent Cell Phone

Parent Email Address

Emergency Contact Person 🛈

Emergency Contact Person's Cell Phone Number

Camper-Singer Health Info

Please list any dietary restrictions or food allergies:

Are there any health concerns, including physical, psychiatric, or behavioral issues, of which we need to be aware? *

Please complete the VIP Camp, Tour and Travel Packet which includes our Health Information Form and return it by June 13. You may return the packet via email to HollyRLee@gmail.com; in person at VIP Rehearsals; or via mail to Holly Lee, 3175 Hickory Ridge Road, Dunkirk, MD 20754.

Payment

Camp Cost: $325 per student. Costs include overnight accommodations in West River cabins; all meals; choral sheet music; all camp activities; transportation to National UMC in Washington, DC; and a camp Tshirt.

Deposit due with registration; Final payment due by June 13, 2019.

Please complete the registration with the deposit. You may pay by cash, check, or credit card.

Amount to Pay Now

I'm receiving a scholarship.

My church is sponsoring me.

Deposit only ($150)

Full payment ($325)

If you have a promo code, please enter it here:

Total:

$0.00

Payment method:

I'm receiving a scholarship.

VIP Account (for current VIP singers only)

Check made payable to VIP and mailed to VIP: 3175 Hickory Ridge Road, Dunkirk, MD 20754. All checks must be received within 2 weeks of form completion.

Credit card. A 3% convenience fee will be added to all credit card processing

Credit card orders are processed by PayPal. Once your form has been submitted you will be forwarded to PayPal where you will then enter in your payment information.

Parent Signature

Waiver

I hereby give permission for my child to participate in Voices In Praise Youth Choir Camp, scheduled to take place from August 10 - 13, 2019. While great care will be taken to ensure my child’s health and safety, I understand that my child’s participation may result in an unexpected illness, injury, dismemberment, or death due to accidents, forces of nature, or other unforeseeable events. I realize that there are certain risks arising from this activity, and I am willing to assume such risks.

By signing this document, I certify that I have legal custody of the child listed on this form. I also certify my child is in good physical and mental health at this time, and that I will submit to the Group Leader a complete and accurate Health Information Form, along with a copy of my insurance card.

I give permission for the adult leaders named above to seek medical treatment for my child. In the event of an emergency, I consent for my child to receive such medical treatment and/or surgical procedures deemed necessary by medical personnel. I, on behalf of myself, my personal representatives, heirs, assigns, and/or designees, hereby agree to hold harmless and fully and forever release and discharge Voices In Praise, Inc., and all trustees, officers, agents and volunteers, employees and/or staff of Voices In Praise, Inc. from any and all claims, demands, rights of action, present or future, whether the same be known, anticipated or unanticipated, resulting from, or arising out of, or incident to, the providing of this medical assistance.

I assume liability for any medical expenses involved. I understand that every reasonable effort will be given to contact me as soon as possible should an emergency arise.

This release shall be in effect during the time that the above-named minor is participating in the Voices In Praise Youth Choir Camp.

Parent Signature *

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