Camp M.O.R.E – Adventure 2026 Camp M.O.R.E. - Adventure 2026 Application Camper's InformationIs your student a current member of STREETS?* Yes Non STREETS Member Camper's First Name*Camper's Last Name*Camper's Home AddressStreet AddressCityStateZipAdditional InformationGender Female Male Date of Birth XX/XX/XXXX - REQUIRED* MM slash DD slash YYYY Race/Ethnicity - REQUIRED*AsianBlackHispanicMultiracialNative AmericanPacific IslanderWhiteSchool - REQUIRED*Kingsbury ElementaryKnight Road ElementaryLaRose ElementaryLowrance Elementary SchoolParkway Village ElementarySheffield ElementaryOtherCurrent Grade in School (2025-2026)*123T-Shirt Size*Youth SmallYouth MediumYouth LargeYouth XLOtherCamper's Health InformationHealth Concerns: Please include all allergies. Type None if there are no health concernsEpi Pen Carries an Epi Pen Parent/GuardianParent/Guardian* First Last Parent/Guardian Email* Parent/Guardian Cell Phone*Parent Guardian/Work PhoneEmergency ContactEmergency Contact Name (Must be different from Parent/Guardian) First Last Emergency Contact Cell PhoneEmergency Contact Work PhoneWaiver and ReleaseField Trips ConsentMy child has permission to attend local field trips during camp with Streets Ministries from Monday, June 8th to Thursday, July 9th, 2026. Streets Camp Inspire participants will attend local field trips this summer. I acknowledge that my child will be participating in exciting and at times physically active events. Students will be transported by a Streets Ministries van, and multiple Streets staff members will be chaperones for the trip. I realize that risks and dangers may arise from foreseeable and unforeseeable events. By signing below, I agree to hold harmless Streets Ministries, or their employees and / or agents for incidents arising from travel to, from and during these stated field trips. In the event that I cannot be reached in a medical emergency, I hereby give permission to Streets Ministries and its authorized agents to secure medical treatment for my child. I agree to the Field Trips Release.Photo and Video ConsentI hereby grant Streets, its agents and those by whom it is commissioned, unrestricted and unlimited license, right, permission, and consent to use and reuse, copyright, print, reproduce, publish, and republish, for any and all trade purposes or commercial or other advertising or public purposes, said media usage depicting me or a minor for whom I have legal responsibility. Media images include: 1) picture- including photographic, motion picture, and electronic (video) image. 2) Voice- including sound and video recordings. I warrant that I have not limited or restricted the use of my name or my child's or photograph to the use of any organization or person. I agree to the Photo and Video Release.Educational Records ReleaseI, the undersigned, do hereby grant my child's school to release the following, but not limited to, academic records to Streets Ministries: -Report Cards -Progress Reports -Standardized Test Results for the purpose of accessing the effectiveness of Streets educational programs and identifying areas of opportunity for growth within those programs. The information provided will be maintained confidentially and is limited to individuals that work with your child at Streets with a legitimate need to know. I agree to the Educational Records Release.STREETS Member Expectations Agreement* I declare to honor the STREETS Ministries Expectations Agreement. Failure to do so, may result in termination of membership privileges. STREETS Code of Conduct is as follows: Respect For Self & Others -No fighting or fake fighting -No inappropriate interactions or public display of affections between students -No use of profanity, bullying, harsh language, or checking (making fun of others) -No lewd or inappropriate articles of clothing or behavior (including, without limitation, students must always wear shirts and shoes) Respect For Authority -Abide by the Expectations and follow all instructions given by staff Respect For Property -Do not damage ANY property on the site inside and outside of the building Respect For Safety -No loitering outside the building -No running in the building unless in the gym -No weapons on the property -No gang affiliated activities or paraphernalia -No drugs or alcohol are permitted on the property -No lewd or inappropriate behaviors, gestures, or actions towards any other campers, volunteers, or staff Consequences For Disciplinary Infractions -Fighting – dismissal from Streets summer camp activities -Fake fighting/Profanity/Checking/Running in the building – 1st time warning, 2nd time dismissal for one day, 3rd time is dismissal for 1 week -Lewd or inappropriate clothing – student will be given the opportunity to change clothes, if unable to, parent will be contacted for student dismissal -Disrespect to any staff/Intentional damage to property/Weapons on property/Gang paraphernalia/Gang activities – immediate dismissal for a length of time to be determined by staff (may result in permanent dismissal from Streets' facility, programs, and activities) I agree to the STREETS Member Expectations Agreement.Waiver and Release*I declare that I am the parent or legal guardian of the minor listed above. I understand the "open door" policy which allows individuals to come and go as they please and Streets Ministries accepts no responsibility for keeping my child in the building or on the premises. I acknowledge that I have received, understand, and accept the terms of the Streets Ministries Expectations ("Expectations"). My child's violation of the Expectations may result in the stated consequences, including, without limitation, permanent dismissal form the Streets facility. I understand that use of the Streets facility may involve risk of bodily injury, mental injury, or property damage and I agree to assume any such risks on behalf of my minor child. I understand that it is up to me to consult physicians or other professionals to make sure that my child can safely participate in activities and events at Streets. My decision to allow my child to participate at Streets based on my independent investigation and knowledge and not the representations of any Strees employee or representative. I also understand and agree that by signing this agreement, I relinquish any right, claim, action, or case of action (and/or the rights for the minor(s) for who I sign) may have against Streets Ministries, its agents, employees, volunteers, assigns, or successors, including, without limitation, the right to sue them for bodily injury, property damage, or any other loss I or my child may suffer while my child uses the Streets facilities. I acknowledge that I have read this waiver and release and that I understand the words and language in this waiver and release. I understand that I am responsible for and/or my minor child's welfare and supervision. This is a waiver and release of liability. DO NOT "SUBMIT" if you: a) Have not carefully read this entire waiver and release; b) Do not understand any part of the waiver and release; c) Need additional time to evaluate or consider this waiver and release; d) Do not agree to be bound by every term of the waiver and release. I agree to the Waiver and Release.Covid-19 Waiver and Release*I, ______________, the parent/guardian of ______________, agree to allow my child to participate in activities and programs at Streets Ministries, Inc. (hereinafter “Streets Ministries”), in consideration for the opportunity for my child to participate in Streets Ministries’ programs and activities for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, agrees as follows: 1. Release of Liability. I hereby forever release Streets Ministries, its board members, officers, employees, staff, directors, and any agents of any kind thereof (hereinafter collectively the “Released Parties”), from any and all liability, loss, damage or expense related to the COVID-19 pandemic arising from or out of my child’s participation in any activities or programs at Streets Ministries, including, without limitation all costs, damages, claims or assertions of any kind or nature with respect to which I or my family, my estate, my heirs, my successors or my assigns might have or could or might have against the Released Parties. 2. Release of Liability—Third Parties. I hereby forever release Streets Ministries and the Released Parties from any and all liability, loss, damage or expense related to the COVID-19 pandemic, including, but not limited to, bodily injury or illness to myself or my child, including death, caused by any acts or omissions of any kind or character whatsoever of any third parties related to, or connected in any way with the Program, including without limitation any costs, damages, claims or assertions of any kind with respect to which I, my child or my family, estate, heirs, successors or assigns may claim against the Released Parties. 3. Assumption of Risk. I understand and hereby acknowledge, independently of any advice or representation made by Streets Ministries, that participation in activities or programs at Streets Ministries during the COVID-19 pandemic presents certain risks beyond Streets Ministries’ control, and which may exist regardless of whether Streets Ministries controls or attempts to control such risks and even if Streets Ministries exercises the utmost care in trying to prevent anyone from getting injured or sick. I am permitting my child to participate in activities and programs at Streets Ministries with this understanding and hereby knowingly and voluntarily assume all risks of injury, illness, death or damage related to COVID-19 which may arise as a result of my child participating in activities or programs at Streets Ministries. My child’s attendance and participation in in programs and activities at Streets Ministries is voluntary, and I understand and hereby acknowledge that I may choose to not have my child attend Streets Ministries, or I may discontinue my child’s attendance at Streets Ministries at any time in light of the risks I am assuming hereunder. 4. Streets Ministries’ Rules and Regulations. I acknowledge and agree that Streets Ministries and its board members, officers, faculty, staff or agents as Streets Ministries deems necessary, shall have the authority to establish rules and regulations regarding my child attending and/or participating in activities at Streets Ministries. Specifically, Streets Ministries can disallow my child attendance or participation in activities at Streets Ministries if it is determined that my child has symptoms of COVID-19. To that end, I agree to permit Streets Ministries to take my child’s temperature upon arrival at Streets Ministries and at any other time that my child is at a Streets Ministries facility. I further agree to monitor my child’s temperature and condition before allowing him or her to participate in any activities at Streets Ministries or sponsored by Streets Ministries and agree that I will not allow him or her to participate in any Streets Ministry activity if my child is showing any sign of illness. I agree that my child and I will follow and be bound by the rules and regulations contained in this paragraph and all other Streets Ministries’ rules and regulations. 5. Insurance. I understand and hereby acknowledge that Streets Ministries has no insurance that will pay for, or reimburse me for, any expenses of any kind which I may incur for treatment of illness or injuries sustained while participating in any programs at Streets Ministries. I hereby assume all responsibility for any such expenses. 6. Governing Law and Severability. I agree that this Waiver and Release shall be construed in accordance with the laws of the state of Tennessee. The terms and provisions of this Student Waiver and Release shall be severable, such that if the arbitration panel determines any term of this agreement to be illegal, unenforceable or in conflict with applicable law governing this Waiver and Release, the validity of the remaining portions shall not be affected thereby. 7. Representations. : (i) I am an adult and I am the parent/guardian of ________________________________; (ii) I have the legal capacity to execute and to be legally bound by this agreement with Streets Ministries and waive certain of my legal rights as provided herein; and (iii) I have read each paragraph and fully understand the terms and conditions of this Waiver and Release and have been provided with the opportunity to discuss it with anyone of my choosing, including a lawyer. I agree to the Covid Waiver and Release.Today's Date* MM slash DD slash YYYY Enter your online signature*By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application. This field is hidden when viewing the formWaiver and Release 2This field is hidden when viewing the formPhoto and Video Release 2This field is hidden when viewing the formEpi Pen 2This field is hidden when viewing the formEducational Records Release 2This field is hidden when viewing the formSTREETS Member Expectations Agreement 2This field is hidden when viewing the formCovid Waiver and Release 2