ARE YOU REGISTERING

A YOUTH 17 AND UNDER?

NOTE:  All attendees who are Under the age of 18 Years of Age (infant through 17)  who are staying in any Hampton University Residence Hall must submit a completed Summer Program Medical Clearance Form. and Permission Slip and Liability Waiver Form. There are no exceptions.

Download both forms below,

complete, sign, save to PDF and email. A Late Fee of $20.00 will be added on July 1, 2018

Email Completed Forms to: 2nddistrictofficestaff@gmail.com

 Please read Parent/Guardian Instructions Listed Below Each Document

 

Parent/Guardian Instructions:

  1. Download the Permission Slip and Liability Waiver Form for each youth 17/under being registered

  2. Print the form

  3. Enter all required data, sign and date

  4. Scan to PDF

  5. Email completed PDF to: 2nddistrictofficestaff@gmail.com 

Required | Medical Clearance Form | Required

Parent/Guardian Instructions:

  1. Download the Summer Program Medical Clearance Form for each youth 17/under being registered

  2. Print the form

  3. Parent or Guardian: Enter all required Personal Data Section

  4. Parent/Guardian: Provide the form to your health care provider for completion of data, signature and date 

  5. Scan completed form to PDF

  6. Email completed PDF to:  2nddistrictofficestaff@gmail.com

The Second Episcopal District of the
African Methodist Episcopal Church
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James Levert Davis, Servant Bishop

Arelis Beevers Davis, WMS Supervisor

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