Camp Omega Registration
AUGUST 5-9
CHILD INFORMATION:
Please add a row for each child attending camp.
*
Pre-K only: Due to the amount of time spent outdoors during the day, children must be potty trained to attend camp. I confirm that my child is potty trained.
Yes
No
PARENT/GUARDIAN INFORMATION:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Authorized Pick-ups
Please list individuals who are authorized to pick your child(ren) up from camp.
*
MEDICAL INFORMATION
Medical Concerns/Allergies
*
I give permission for RLC to seek treatment in the event of an emergency.
*
Yes
No
Emergency Contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Questions
I authorize RLC to apply sunscreen/bug spray to my child(ren).
Yes
No
Other
RLC will provide a lunch each day at camp. Will your child be eating camp lunch or bringing their own lunch?
*
Camp lunch
Bring lunch from home
Other
I give permission and consent to allow photographs to be taken during Day Camp. These photos may be published on the Redeemer Lutheran Church Facebook page, website, or used in printed materials.
*
Yes
No
How did you hear about us?
*
Please Select
I go to Redeemer
Friend
Newspaper
Online
Other
Please Specify
Signature of Parent/Guardian
*
Continue
Continue
Should be Empty: