Kids Camp Registration Form
Please complete one per child
July 27th - July 31st, 2026
from 9 -12
Child's Name
*
First Name
Last Name
Child's Age
*
Grade Entering in 26-27 School Year
*
Reminder: Kid's Camp is for children ages 4 years old through rising 5th graders
Parent/Guardian's Name
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Secondary Parent/Guardian's Name (if applicable)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
I give permission for my child to be photographed during Kid's Camp, and used for future promotional purposes
*
Yes
No
Medical/Emergency Information
Please list any allergies or medical conditions that staff need to be aware of while your child is at Kid's Camp. (note that staff will not be able to administer medications)
*
Emergency Contact:
*
First Name
Last Name
Emergency Contact Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to child:
*
Please list any additional adults who are authorized to pick up your child from Kid's Camp:
*
Submit
Should be Empty: