Shetek Day Camp 2019 at FLC
Camper Registration and Health Form
First Lutheran Church, St. Peter
Camp is June 24-27, 2019
9 a.m. - 2:30 p.m.
Cost: $50/camper; $120 family maximum
Payable to First Lutheran Church
Snack is provided. Campers bring their own lunch.
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Email *
Camper's Name (First and Last) *
Gender
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Age
Grade entering in fall 2019
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Birthday
MM
/
DD
/
YYYY
Address (street, city)
Parent or Guardian Name
Primary Phone Number
Preferred email
Name of emergency contact
Relationship to camper
Emergency contact phone number
Name of alternate contact
Relationship to camper
Alternate contact phone number
Family physician's name/clinic
Phone number of clinic
Indicate any special physical, dietary, or emotional needs of the camper
Current medications
Authorization of parent/guardian: I hereby give my permission for my child to participate in day camp and activities planned by the Shetek staff for the day camp program. Shetek Lutheran Ministries may use any pictures or videos that my child appears in for promotional purposes. I also authorize delivery of necessary emergency care by available medical personnel as needed.  
How did you learn about day camp at First Lutheran church?
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