Leader in Training Registration Form
I am registering my child who has completed 7th grade as a Leader in Training in
Kern County/Central California (July 15th-18th, Sierra Christian Service Camp in Posey, California.)
Northern California (June 21st-24th, Cazadero Baptist Camp, in Cazadero, California.)
LIT Full Name
*
First Name
Last Name
Church Name
*
LIT's most recent grade graduated
*
LIT's Gender
*
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Relationship to LIT
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Any medical conditions we should be aware of? (e.g., allergies, medications)
Does your child have any special needs or require accommodations?
Parent Signature
*
Leader in Training Signature
*
May we use your child's image for advertising purposes?
Yes
No
Register and Go to Payment Platform
Register and Go to Payment Platform
Should be Empty: