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
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
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.
YESNO
PAYMENT

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