Day Camp Reunion and Family Fun Day!

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* These fields are required

1 Welcome to Ingalls Creek Enrichment Center!

2 How many vehicles are you registering?

3 People in your group

4 About you

Phone
Mailing Address
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact name, phone number, email, relationship to you	Who can we contact on your behalf in case of emergency during this event? Provide their name, phone number, email address, and relationship to you.
Liability Release	I have read the Liability Release below and I agree to the stated terms. Ingalls Creek Enrichment Center Events Liability Release/Consent statement: All reservations and registrations are subject to confirmation and approval by Ingalls Creek Enrichment Center management. Agreement to this release statement is required for your participation. Hold Harmless: The individual(s) named in this registration agee(s) to indemnify, hold harmless, and defend Ingalls Creek Enrichment Center (ICEC) and its agents and employees from any and all loss or liability arising from participation in activities and events organized by ICEC and the use or occupancy of ICEC premises by any persons whomsoever during the time ICEC is used or occupied by the registering individual. This includes any and all housing accommodations (extending to Alanna’s Landing if used during an ICEC event), parking, trailer parking, tent camping or glamping, trail use, and use of ICEC vehicles. This hold harmless agreement includes, but is not limited to, any claim for personal injury or death of any ICEC participants, personnel, contractor employees, agents’ invitees, and/or servants. Please Note: Ingalls Creek Enrichment Center reserves the right to deny use or to terminate use privileges to any individual or group that the ICEC board or its representative determines to be harmful to facilities, ministries, or purposes of ICEC, including disruptive or undesirable behavior impacting neighbors or other users. ICEC purposes are stated in the bylaws of Ingalls Creek Enrichment Center, with particular emphasis on Article IV, Tenets of Faith, and in the ICEC vision statement, available on request.
Photo release	I/we (if multiple guests are registering together) grant permission to Ingalls Creek Enrichment Center to photograph me/us and to use the photographs, video and/or film in ICEC audio-visual and printed materials without compensation or approval rights.
How many people people do you expect to bring in your vehicle?

5 Optional donation

6 Security Check

7 Payment

	By submitting payment, you authorize Ingalls Creek Enrichment Center to instruct your financial institution to take payments from your account in accordance with your agreement with Ingalls Creek Enrichment Center.