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Kid's Camp Registration Form 2022
***Note: All children must be 3rd - 5th grade
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Parent/Guardian Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Primary Phone Number
*
Your answer
Secondary Phone Number
*
Your answer
Home Church
Your answer
Email Address
Your answer
Emergency Contact Number
*
Your answer
Adults who will pick up your child
*
Your answer
Child 1
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
DOB
*
Must be 3rd -5th grade
Your answer
Grade Completed
*
Your answer
School Attending
*
Your answer
Allergies/Medications/Health Concerns
*
Your answer
Friend your child would like to have in their group.
Your answer
Additional notes regarding your child
Your answer
Child 2 If Applicable
If you have no more children to register, please scroll down to the bottom of this form to submit it.
Child's Last Name
Your answer
Child's First Name
Your answer
DOB
Must be 3-yrs by June 1st & potty trained.
Your answer
Grade Completed
Your answer
School Attending
Your answer
Allergies/Medications/Health Concerns
Your answer
Friend your child would like to have in their group.
Your answer
Additional notes regarding your child
Your answer
Child 3 If Applicable
Child's Last Name
Your answer
Child's First Name
Your answer
DOB
Must be 3-yrs by June 1st & potty trained.
Your answer
Grade Completed
Your answer
School Attending
Your answer
Allergies/Medications/Health Concerns
Your answer
Friend your child would like to have in their group.
Your answer
Additional notes regarding your child
Your answer
Child 4 If Applicable
Child's Last Name
Your answer
Child's First Name
Your answer
DOB
Must be 3-yrs by June 1st & potty trained.
Your answer
Grade Completed
Your answer
School Attending
Your answer
Allergies/Medications/Health Concerns
Grades 1-5 Complete
Your answer
Friend your child would like to have in their group.
Your answer
Additional notes regarding your child
Your answer
Child 5 If Applicable
Child's Last Name
Your answer
Child's First Name
Your answer
DOB
Must be 3-yrs by June 1st & potty trained.
Your answer
Grade Completed
Your answer
School Attending
Your answer
Allergies/Medications/Health Concerns
Grades 1-5 Complete
Your answer
Friend your child would like to have in their group.
Your answer
Additional notes regarding your child
Your answer
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