Fellowship with Holy Spirit 2026 Summer Camp Registration Form

Fellowship with Holy Spirit 2026 Summer Camp Registration Form

1275 E Broadway, Anaheim CA92805 June 15(Mon) - June 18(Thur) Daily Hot Lunch and snacks Served*
Child/Participant's Full Name*

First NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Child Age
Grade(as of Fall 2026)*
Parent/Guardian Full Name*

First NameLast Name
Relationship to child*
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Please list any allergies, medical conditions, or special needs*
YesNo
Yes, I authorizeNo, I do NOT authorizeNot applicable (my child does not require medication)
Pediatrician Name
Pediatrician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Insurance Information
Additional Comments or Requests
AuthorizeDo Not Authorize
I understand that my child is expected to follow all camp rules and staff instructions.I acknowledge that participation in this camp requires a signed waiver, and that my child may not participate until the waiver is completed.I understand that registration is only considered complete after BOTH payment and waiver are received.I give permission for my child to participate in all camp activities.I confirm that all information provided in this form is accurate and complete.
YesNo

My Product*

Fellowship with Holy Spirit 2026 Summer Camp

$120.00 Quantity

Volunteer Family Registration

Complimentary - Only for pre-approved volunteer families. Unauthorized selection will result in cancellation.

$ Free Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: