Adaptive Vacation Bible Camp at Eden Prairie UMC

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Thank you for registering your child. We are pleased to offer this free experience as part of our expanding Autism Ministry. Dates are August 7 -10, 10 a.m. to noon. We are happy to partner with Good Samaritan UMC this summer. This camp is for children 3.5 years and up. Please fill out this form completely; there are two sections.

Email *

Registration Information

Basic information about your child and emergency contact information.

Name of Child *

Date of Birth *

Grade completed spring 2023 *

Gender *

Special Needs/Allergies *

Name of Parent(s)/Guardian *

Address *

Preferred Phone Number *

Emergency Contact (name and phone number) *

Relationship of Emergency Contact to child *

If someone other than parent/guardian will pick up your child, please provide name and phone number.

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