Kids Camp Registration Form
Please complete one per child
July 29th - August 2nd, 2024
from 9 -12
Child's Name
*
First Name
Last Name
Child's Age
*
Grade Entering in 24-25 School Year
*
Reminder: VBS is for children in grades Prek through 5th Grade
Parent/Guardian's Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Secondary Parent/Guardian's Name (if applicable)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
I give permission for my child to be photographed during Kids Camp, and used for future promotional purposes
*
Yes
No
Medical/Emergency Information
Please list any allergies or medical conditions that staff need to be aware of while your child is at Kids Camp. (note that staff will not be able to administer medications)
*
Emergency Contact:
*
First Name
Last Name
Emergency Contact Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to child:
*
Submit
Should be Empty: