Summer J.A.M. Registration

Summer J.A.M. Registration

Child Evangelism Fellowship of NC Western Piedmont Chapter
Thank you for your intrest in registering your child for Summer J.A.M. this year!

Summer J.A.M. is for designed for children ages 5-12. If you are registering more than one child, please fill out a separate form for each child.

If you have questions or concerns, please call 704-871-2424
Child's Name*

First NameLast Name
Child's Birthday*

MonthDayYear
Date
Grade Completed*
Kinder, 1st, 2nd, etc.
Allergies
We will be providing snack and candy prizes
Enrolled by:
Name*

First NameLast Name
Relationship to child*
Parent, grandparent, guardian, etc.
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Photo Release: (optional)

I grant permission to CEF Western Piedmont to use photographs of my minor child listed above in print or online materials designed for promotion, informational or educational purposes related to Child Evangelism Fellowship. I understand that my child’s name and location will not be used in any promotions.
Parent/Guardian Signature
Note: your typed signature is legally binding. If you prefer to give a written signature, you may print your name here and then write your signature in the box below.
Parent/Guardian Written Signature (optional)

Clear
I am enrolling my child for Summer J.A.M. at the following location:*
Parental Permission*

The child listed on this form has my permission to attend the selected Summer J.A.M. day camp
Parent/Guardian Signature*
Note: your typed signature is legally binding. If you prefer to give a written signature, you may print your name here and then write your signature in the box below.
Parent/Guardian Written Signature (optional)

Clear
Should be Empty: