Preschool Summer Camp

Firm Foundation Academy Summer Camp

June 1st - June 26th | 8:00AM-4:30PM
Child's Name

First NameLast Name
Birthday

MonthDayYear
Date
Age
Nickname
Photo Permission
Please select a t-shirt size for your child. (youth sizes)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mom's Full Name

First NameLast Name
Mom's Cell #
Please enter a valid phone number.Format: (000) 000-0000.
Mom's Work #
Please enter a valid phone number.Format: (000) 000-0000.
Home #
Please enter a valid phone number.Format: (000) 000-0000.
Dad's Full Name

First NameLast Name
Dad's Cell #
Please enter a valid phone number.Format: (000) 000-0000.
Dad's Work #
Please enter a valid phone number.Format: (000) 000-0000.
Home #
Please enter a valid phone number.Format: (000) 000-0000.
Allergies/Medical Conditions
Emergency Contact & Release of Child
Emergency Contact #1
Emergency Contact #1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Emergency Contact #2
Emergency Contact #2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Emergency Contact #3
Emergency Contact #3 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
I First Name Last Name give Firm Foundations & International Praise Church of God permission to obtain emergency treatment for my child while in their care.
I certify that I have completed this form accurately and agree to notify Firm Foundations and International Praise Church of God of any changes by promptly updating this form.
Signature
Today's Date

MonthDayYear
Date
Should be Empty:

Firm Foundation Academy Summer Camp