Give the gift of registration with a voucher for a friend

Amount$

Recipient Email

We will send an email with the voucher code.

Add Voucher

Donate to a student in need

SEND A KID TO CAMP

Do you have a specific student you would like to donate too?

Register your student

Student Name

Student Gender

Male
Female

Student Grade (2025-2026 school year)

Student School

Yay! You get a free T-Shirt. Tell us your size.

Parental Consent Form

Parents and legal guardians of minor children are asked to complete this form and return it to Jesus Culture San Diego, hereinafter collectively referred to as JCSD. The information requested is designed to assist JCSD in providing for the safety of minors during JCSd sponsored activities

Parent / Guardian Name #1

Parent / Guardian Name #2

Parent / Guardian Email

Parent / Guardian Phone Number #1

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Parent / Guardian Phone Number #2

Child's Address

Health Insurance Company Covering Child

Policy Number

Family Doctor

Doctor's Phone Number

Child's Date of Birth

List any activities you DO NOT AUTHORIZE your child to participate in:

CONSENT AND CERTIFICATION:

I / we, being the parent or legal guardian of the child named above (the "child"), do hereby consent to the participation of our child in the activities of JCSD VBS , 6/23 - 6/26. JCSD:10330 Carmel Mountain Road, San Diego, CA 92129

ON CAMPUS ACTIVITIES including, but not limited to: Activities including, but not limited to, Ultimate Frisbee, Basketball, Volley Ball, Dodge Ball, Tug-of-war, Football, Bouncey House Jumping,in which participants may be subject to bites from insects bites, sunburns and the occasional bumps and bruises. .

I / we hereby represent that child is in good health and in proper physical condition to participate in the above activities. Further, I / we certify that my child is physically able and adequately trained to participate in such events, including water activities . I / we understand and acknowledge the physical rigors associated with the activities and understand that participation involves risks and dangers which include, without limitation, the potential for serious bodily injury, permanent disability, paralysis and death; inaccessibility of medical care; dangers arising from adverse weather conditions; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of JCSD; and other undefined harm or damage which may not be readily foreseeable, and other presently unknown risks and dangers ("Risks"). I / we understand that these Risks may be caused in whole or in part by child’s own actions or inactions, the actions or inactions of others participating in the activity, and I / we hereby expressly authorize our child to participate in the above activities.

I have read and agree to the terms above.

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