CentriKid Registration
CentriKid is a summer camp designed for 2nd-5th graders. This year our 2nd-5th Graders will be going to Timbercreek Camp in Pulaski, MS, June 29 -July 1. The total cost is $205. 

To claim a spot, parents must complete this registration form and submit a $100 deposit by February 5, 2024.
Note: A deposit secures a spot.   

The final balance is due June 3, 2024.

Scholarships are available for CentriKid 2024. For more information please contact Jennifer in the church office at (601)635-2828.
Sign in to Google to save your progress. Learn more
PARTICIPANT INFORMATION
Child's Name *
Grade Completed as of Summer 2024 *
Child must have completed the 2nd Grade in order to attend camp.
Parent's name *
Parent's Phone Number *
Parent's Email *
Parent's Address *
DIETARY INFORMATION
Does the participant have any dietary restrictions or allergies that we need to be aware of for camp. *
If yes, please explain. *
Payment Information (Please read the following)
The completion of this form and submission of your $100 deposit is required to secure a spot for camp. The total balance for CentriKid is $205. 

Deposits are due February 5th. ALL spots without deposits will be released to Lifeway after the deposit due date. We will not be able to guarantee a spot after this date. Any registrations after February 5th will be waitlisted. 

Final Balances are due June 3. If you have any questions about payment, please contact Jennifer in the church office, 601-635-4445. 
Do you understand the above Payment Information? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy