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Camp dates for 2024 are June 17-20 from 5:30-7:15pm meeting at the WCHS track--but stay close to your email as our rain location is Bethany Community Church, 27577 Dutch Lane in Washington. Thank you for registering for the WCHS Distance Camp. The coordinator, Ben Davidson, is an assistant track coach at WCHS as well as on staff at Bethany Community Church. The church website is being leveraged for registration purposes. Please read carefully. To register correctly, you'll need the following information. As you register, you will be asked to initial that you read all of the below,,, I, the undersigned parent/guardian, hereby consent to my children and any participating adults in my family in activities connected with BETHANY COMMUNITY CHURCH in Washington, IL and WASHINGTON COMMUNITY HIGH SCHOOL in Washington, IL. I certify that my family member or I am able to participate in these activities including running, walking, etc. (unless otherwise indicated). If there are any activities I do not want my child, family member, or myself to be involved in I have listed them.
I UNDERSTAND AND HERBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. If I, my child, or adult in my family has any medical conditions, which may be relevant to a physician in the event of an emergency, I have listed them. In the event that an emergency occurs, I may be reached at the telephone number(s) listed. If I cannot be reached within a reasonable period of time, I hereby authorize the camp staff to make emergency medical decisions for those within my family. I consent to the use of my, my family or individual family member's portrait or picture for purposes of trade, publicity, and or information by BETHANY COMMUNITY CHURCH and WASHINGTON COMMUNITY HIGH SCHOOL.
I do hereby agree to hold BETHANY COMMUNITY CHURCH and its agents and employees, as well as WASHINGTON COMMUNITY HIGH SCHOOL and its agents and employees, harmless from any and all liability, actions, causes of action, claims, expenses, and damages on account if injury to my, my child, my family member or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity to participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the State of Illinois law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release and contractual and to a mere recital. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read and understand. Here is some more info: Please arrive 10 minutes early (5:20pm) at the WCHS track to check in and pay for your $40 fee on Monday, June 17. Check in will be near the PantherPlex buildling off of Wilmor Drive. You can pick it up your shirt at check in. Keep an eye on your email as bad weather will have us meeting at the same times at Bethany Community Church to run indoors. The address is 27577 Dutch Lane in Washington. Walk-ins are welcome but shirts won't be avialable for walk ins. Remember to bring a water bottle, have good running shoes, and a good attitude!
Ben Davidson WCHS Asst. Track Coach, Boys Distance Team Cell: 309-472-2388 ben@bethanycommunitychurch,.org Twitter: @wchstrackxcmen Facebook: facebook.com/wchstrackxcmen Instagram: wchstrackxcmen
* = required field
*Child Name:
*Parent/guardian name:
*Parent/guardian phone:
*Email address
*Address, City, State, Zip
*Emergency contact name (different than name/number above):
*Emergency contact phone (different than name/number above):
*List all people allowed to pick up your child(ren) including yourself (name 1, name 2, etc.):
*My initials in this field express my agreement with the release form at the top of this webpage:
Dietary/medical issues we need to be aware of:
*Shirt size:
Child S Child M Child L Child XL Adult S Adult M Adult L Adult XL Adult XXL
*My initials here give my commitment to paying in full upon arrival the cost of $40:
*My child's grade this fall:
5th grade 6th grade 7th grade 8th grade
*
I acknowledge that registering after Monday, June 10 at 10am may not guarantee a t-shirt.
