PFC Life! Teen Night Out

"*" indicates required fields

Participant Information

Participant Name*

First Last

Participant Age*

Participant Phone Number*

Participant Email

Optional

Parent/ Guardian Information

Parent/ Guardian Name*

First Last

Parent/ Guardian Email*

This is the email we will send event information to prior to PFC Life. Information will also be sent to the participant email if that field is filled.

Parent/Guardian Phone Number*

This is the number we will use to reach you if needed at the event.

Responsibility of Medical Supervision/Treatment*

Due to staffing limitations, Camp Sweeney will not be responsible for the medical supervision and treatment of participants during the PFC Night Out event. Camp Sweeney will not be responsible for providing medical supplies (testing supplies, insulin, juice, etc.) for participants.

I acknowledge and understand that Camp Sweeney is not responsible for medical supervision and/or treatment of participants. As guardian, I give permission for my child to attend this event.

Date*

Please click on the calendar and select today's date.