Spring Break Camp Sign-Up Form

Spring Break Camp Sign-Up Form

Register your children for camp and provide important contact and medical information. For any questions or help, please contact the church at office@rivervalleymission.ca.
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Child Registration

Please provide details for each child you wish to register.
Children's Information*
Emergency Contact Information*
Pickup Person Information*
Signature

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty: