Mercy Kids Camp Registration Form
Kids Camp (Ages 5+): Fun & Supervised Activities for Children During BA Day! Children under 5 are welcome with a caregiver to assist with personal care needs.
Child's Name
*
First Name
Last Name
Age of Child (At time of Camp)
*
Parent/Guardian Name:
*
First Name, Last Name
Parent/Guardian Phone Number:
*
Please enter a valid phone number.
Please list any allergies (Enter "N/A" if not applicable):
*
Additional Comments
Parent/Guardian Signature:
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Should be Empty: