Waitlist Union Baptist Church Centershot Camp

Union Baptist Church Centershot Camp

Waitlist Form
Preferred class time

9:00 AM - 12:00 PM1:00 PM - 4:00 PM
Child's Full Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Gender

MaleFemale
School grade entering in August 2025
Has your child participated in the National Archery in Schools Program (NASP)?*

YesNo
What is your child’s dominant eye? If unsure, what hand do they use to write?*

Right eye dominantLeft eye dominant
Does your child have their own Genesis bow?*

YesNo
Parent/Guardian Name*

First NameLast Name
Parent or Guardian Phone Number*
Please enter a valid phone number.
Parent or Guardian Email Address*
example@example.com
Parent or Guardian Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact (if we are unable to reach you immediately)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Emergency Contact Relationship*
Consent to Participate*

I agree to the safety rules and guidelines of Union Baptist Church.I consent to having my child's photographs taken during activities for promotional purposes.
Additional Information

Please provide any additional information or medical conditions we should be aware of.
Additional Notes or Medical Conditions
Should be Empty:

Union Baptist Church Centershot Camp