Go Fish! Camp Registration Form 2023

Go Fish! Camp 2023

at Lake Eva Community Center
Boys & Girls - Ages 9 & Up
May 1-3, 2023
9am - 3pm
$85.00 per camper
How many children are you registering?*
Child Information
First Child
Child's Name*

First NameLast Name
Age*
Gender*
Child's Birth Date*

MonthDayYear
Medical or other information we may need to know about the child (including food allergies).
Second Child
Child's Name*

First NameLast Name
Age*
Gender*
Child's Birth Date*

MonthDayYear
Medical or other information we may need to know about the child (including food allergies).
Third Child
Child's Name*

First NameLast Name
Age*
Gender*
Child's Birth Date*

MonthDayYear
Medical or other information we may need to know about the child (including food allergies).
Fourth Child
Child's Name*

First NameLast Name
Age*
Gender*
Child's Birth Date*

MonthDayYear
Medical or other information we may need to know about the child (including food allergies).
Contact Information
Parent/Legal Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Names of persons to which the child (children) may be released other than above Parent/ Guardian
Full Name

First NameLast Name
Full Name

First NameLast Name
Full Name

First NameLast Name
Emergency Contact Information
Emergency Contact 1 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 1 Phone Number

Area CodePhone Number
Emergency Contact 2 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 2 Phone Number

Area CodePhone Number
By clicking the box below, I acknowledge that I have read the Go Fish! Camp 2023 Day Camp Policy & Information Sheet.
*

I Agree
By clicking the box below, I acknowledge that I have read the Go Fish! Camp 2023 Tenative Schedule.
*

I Agree
Hold Harmless Release
By clicking the box below, I hereby release and hold harmless Go Outdoors! Ministries, Inc members and other persons or entities associated therewith from any and all liability which may occur while my child is participating in the Go Fish! Camp program.
*

I Agree
Media Release
By clicking the box below, I hereby give permission for photographs and/or video in which my child appears in to be used by Go Outdoors! Ministries, Inc in printed and/or electronic media, including the website.
*

I AgreeI Disagree
Go Fish! Camp Fee
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Go Fish! Camp Camper $85.00

Quantity

Total $0.00

Payment Methods

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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Go Fish! Camp 2023

Boys & Girls - Ages 9 & Up

May 1-3, 2023

9am - 3pm

$85.00 per camper

Child Information

First Child

Second Child

Third Child

Fourth Child

Contact Information

Names of persons to which the child (children) may be released other than above Parent/ Guardian

Emergency Contact Information

Hold Harmless Release

Media Release