General information  First Name  Last Name  Address  Phone Number  E-mail Address  Emergency Contact  Emergency Contact Name  Number  Relationship  Rules and regulations  Waiver of liability  Acceptance of rules  and regulations  Agreement to pay  Signature of parent  or legal guardian  Date  Comments  Comments      Agreement to pay, unless other arrangements are made in advance in written format. Attach a copy of the form for different payment arrangement. © "Liya" The Christian Camp for Children, 2001 © The Rivne Association of Gospel Christian-Baptist, 2001