Registration Form

Registration Form

College Ministry registration form. Form collects the applicants basic information to be admitted to college. Form Preview
Glorieta 2016 Registration Form
  • Glorieta 2016 Registration Form

  • Basic Information

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  • Medical Questionaire

  • Emergency Contacts

  • Release of Liability/Medical Waiver

  • I recognize that there are risks involved in participating in this camps and hereby assume all risk of injury, harm, damage, or death in connection with my participation in it. I understand and agree that neither Foundation College Ministry nor its trustees, officers, directors, employees, agents or representatives may be held liable in any way for any injury, harm, damage, or death that may occur to me as a result of my participation in this mission trip and hereby release Foundation College Ministry, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death, which may occur while I am participating in the mission trip. To the fullest extent permitted by law, I agree to save and hold harmless Foundation College Ministry, its trustees, officers, directors, employees, agents and representatives from any claim by myself, my estate, heirs, successors, assigns or other persons arising out of my participation in the mission trip.

    I authorize Foundation College Ministry through its trustees, officers, directors, employees, agents or representatives to render or obtain such emergency medical care or treatment for me as may be necessary should any injury, harm or accident occur to me while participating in the camp.

     

    IF APPLICABLE:

    {I understand and acknowledge that Foundation College Ministry does not provide health or medical insurance in connection with the mission trip and I agree that I will be financially responsible for any bills incurred as a result of medical treatment, including emergency medical treatment and/or transportation to a medical facility, in connection with my participation in the camp.

  • FCM Code of Conduct Agreement

  • As an attendee of Glorieta Collegiate Week with Foundation College Minsitry, I agree to the following

    - To respect and submit to all decisions made by FCM leadership on the trip that are not in violation with Christian conscience.

    - To respect and keep the dress code as given by Glorieta Camps and FCM Leadership

    - To abstain from any alcohol or illegal drug use.

    - To seek to be at peace with everyone and show respect to everyone in the group and at the camp.

    - To maintain healthy emotional, physical, and spirtual boundaries with those of the opposite sex, or same-sex attracted. 

    I also agree that:

    - If I am found in violation of the Code of Conduct, or participate in behavior that is deemed innapprorpriate by FCM leadership, I understand that I can be sent home with no refund at my own expense. 

    - That in the event of a last minute cancellation or emergency situation, I understansd that FCM has not responsibility to refund my money paid

  • By Signing Below

  • I submit that I have answered the questions above truthfully and to the best of my ability. I also submit that I have read the form in it's entirety and have agreed to the parameters set forth. 

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