Eco Kids Camp 2018 Registration

Time: from 9:00-4:30 Monday through Thursday with half day on Friday 6/23.

Place: Faith UMC, located at 2708 33rd Ave. NE, St. Anthony, MN 55418

Who: all children entering grades 3-6

Cost: The cost is $100 per camper. Full or partial scholarships are available.

Child one's name and DOB*

Please enter child's name and date of birth

Grade entering 2023*

Child two's name and DOB

Please enter child's name and date of birth

Grade entering 2023

Child three's name and DOB

Please enter child's name and date of birth

Grade entering 2023

Name of parent/guardian*

First NameLast Name

Street Address:*

City:*

ZIP Code:*

Phone Number*

Area CodePhone Number

Text

YesNo

Email Address*

NEW: Our camp fee this year is $100 per child. Please check one of the options, below:*

I can pay the full amount, $100I cannot pay the full amount, but I can pay $50My child can only attend camp with a full scholarship.

Allergies / Special health concerns / dietary needs:

0/750

Insurance Company: *

Insured’s Names*

Policy Number:*

Group/ID Number:*

PARENTS: My child may participate in Eco-Kids Day Camp. I give permission for my child to receive emergency medical care if necessary. I give the adult volunteers, clergy or church staff the authority to act on my behalf with respect to my child’s health and safety while in Eco-Kids Day Camp, with the understanding that I will be contacted as soon as possible should the need arise. I accept full responsibility for any expenses for medical treatment for my child. I release Northeast United Methodist Church, Community United Methodist Church, Faith United Methodist Church and their representatives from liability in the event of accidental injury or illness. Furthermore, my child has permission to participate fully in Eco-Kids Day Camp activities, including field trips.

Using your mouse, please sign below:

Date:

I give permission for images of my child to be used by Faith United Methodist Church in materials celebrating or promoting Eco-Kids Camp. (Names of children will not be used).

Date:

Using your mouse, please sign below:

Registration Payment*

Full Price$100.00

Number attending

Partial Price$50.00

Number attending

Total $0.00

When you click the Submit button, you will be redirected where you can either pay with your Paypal account if you have one or by credit card.

Eco Kids Camp - June 19-23, 2023