2026 Day Camp Registration Form

2026 Day Camp Registration Form

Please fill out your details to register for the camp DETAILS: July 20-24 Drop Off 8:30 AM- Pick Up 3:30 PM $50 Per Child Grades: K-5
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Guardian's Full Name

First NameLast Name
Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Approved Pick Up Person

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Conditions or Allergies (if any)
PAYMENT: You can post payment online. Here is the link to pay: https://app.securegive.com/Madisoncog/main/donate/category

Choose KIDS ACCOUNT and then put childs name in the "add a message" spot on the right. Cost is $50 per child. YOUR CHILD IS NOT CONSIDERED REGISTERED UNTIL PAYMENT IS RECEIVED. If you need assistance please reach out to Monica at 850-869-7690.
Permission Slip: The Madison Church of God will be having our Madison Day Camp, July 20th-24th. I give my child permission to participate in all the activities at the Madison Church of God from July 20-24, 2026. I do hereby give my permission and consent for my child to attend and fully participate in the above-described event. Furthermore, I do hereby release, forever discharge, and agree to hold harmless the Madison Church of God, the church staff, and all youth workers from any liability, claims, or demands of any nature which may be incurred by the above described event(s), including but not limited to personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever. My child will be allowed to participate in other active games. I hereby understand that I do not hold Madison Church of God, the Pastor, Church Leaders, or Youth Sponsors accountable for any harm to my child. In the event of an emergency where medical treatment is required, I give my permission to the church staff and youth workers to obtain the services of a licensed physician. Please attempt to notify me immediately concerning any such emergency.

Please sign to give permission for camp participation.
Should be Empty: