Grace Lutheran Summer Camp Registration Form 2025

Grace Lutheran Summer Camp Registration Form 2025

Join us for a summer of fun and creativity! Please sign up each child individually. Camp runs Monday-Thursday.
Camper's Information

Personal & Health & Contact
Name

First NameLast Name
Birth Date

MonthDayYear
Age (at time of camp)
Grade (entering this fall)
List Any Allergies and Dietary Restrictions
Medications & Frequency
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Information
Name

First NameLast Name
Email
example@example.com
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship with the Camper
Emergency Contacts and Authorized Pick Up Persons
Program Information

Weeks and Payment
Select Camp Week*

Week 1-June 9-12Week 2-June 16-19Week 3-June 23-26Week 4-June 30-July3Week 5-July 7-10Week 6-July 14-17Week 7-July 21-24Week 8- July 28-31Week 9-August 4-7
Select Camp Length

9:00AM-12:00PM $60.009:00AM- 2:00PM $100.00
If signing up for full day, 9:00AM-2:00PM, please send a lunch with your child. We provide snacks, but not a full lunch.
I allow for Grace Lutheran Church to take pictures of my child and use for promotional materials or to share what they are doing at camp.

YESNO
PAYMENT

Please bring payment in cash or check to the first day of camp
Should be Empty: