Stellar Day Camp & Summer Breeze Childcare Registration

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*Nursery - 5yo registration is only for children of those attending Summer Breeze or Kids Camp Volunteers.

Stellar Kids Camp is for those who have finished K-5. For Stellar Kids Camp registration, head to the North Mar app or website.

Email *

Child's First Name *

Child's Last Name *

Child's Date of Birth *

YYYY

Child's Age *

Allergies, medical conditions, or special needs *

Emergency Contact *

Emergency Phone Number *

Relationship to Child *

Permission for North Mar Church to use child's photo online or in printed materials. *

Yes

In the case of a medical emergency, I understand that hospital policy requires parental permission before treatment. I hereby give my permission to an authorized representative of North Mar Church to secure proper medical treatment. I understand that I, as the parent/guardian, will be notified as soon as possible in the event of an emergency. *

Yes

Health Insurance Company *

Health Insurance Policy Number *

North Mar Safety & Consent *

Yes, I consent to let my child participate in the Children's Ministries activities sponsored by North Mar Church.

No, I do not consent

Parent's First Name *

Parent's Last Name *

Parent's Date of Birth

YYYY

Phone Number *

Can we text you at this number? *

Are you volunteering for Kids Camp or attending Summer Breeze? *

Volunteering

Summer Breeze

A copy of your responses will be emailed to the address you provided.

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