Soccer Camp 2026 Registration

Parent / Guardian Info

Parent/Guardian Name

Parent/Guardian - relationship to child

This address will receive a confirmation email

Phone

Additional Parent/Guardian or Pickup Individuals - (Include name, relationship to child, phone number, and/or email address)

Camper 1

Name

Age on June 1

Youth Shirt Size

Allergies / Medical Issues / Other things we might need to know...

Camper 2

Name

Age on June 1

Youth Shirt Size

Allergies/Medical Issues/Other things we might need to know...

Camper 3

Name

Age on June 1

Youth Shirt Size

Allergies/Medical Issues/Other things we might need to know...

Camper 4

Name

Age on June 1

Youth Shirt Size

Allergies/Medical Issues/Other things we might need to know...

Camper 5

Name

Age on June 1

Youth Shirt Size

Allergies/Medical Issues/Other things we might need to know...

Authorization

I Agree (liability waiver)

I hereby give permission for my child to take part in the Faith and Fun Sports Camp and absolve Jackson County Baptist Church from liability to me or my child because of injury to my child while attending.

I Agree (emergency medical treatment permission)

In case of emergency, I understand every effort will be made to contact the parents / guardians. In the event I cannot be reached, I hereby give permission to Jackson County Baptist Church to secure proper treatment for my child.

I Agree (photo release)

I also grant permission to Jackson County Baptist Church to use my child's photograph(s) on its web site or Facebook or in other official church printed publications without further consideration.

Finish Registration and Pay

Choose the number of children you are registering for camp. It is $5 per camper to reserve your spot and get a t-shirt! Input your credit card information. After you input your credit card information, click "Submit and Pay". Once submitted, your child(ren) are registered for Faith and Fun Sports Camp - Soccer!

To confirm that we received your registration and that your payment has gone through, please check your email. You should receive 2 separate confirmation emails:
- one from our church (JCBC Office) confirming registration and
- one from Breeze Church Management confirming payment receipt.

If you have any questions, please feel free to email us at office@jcbaptist.org or call us at 706-367-1838.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Soccer Camp 2026 Registration

Description

Please Fix the Following