Changemakers Camp Registration

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Bridgewater Church of the Brethren is hosting a three-evening event for children called Changemakers Camp June 20-22. This event will feature music, Bible storytelling, activities, and games for children pre-K through elementary age. If your child is interested in attending, please fill out this registration form. Please complete a separate form for each child that will attend.

Child's Name *

Child's Age & Birthday *

Home Church *

Does the child have any known allergies or dietary restrictions? *

Yes

If so, please explain.

Parent or Guardian Name and Phone Number *

Emergency Contact & Phone Number (Please provide an additional emergency contact that is not the parent or guardian listed above.) *

Is the parent or guardian available to assist with supervision during the event? *

Yes

Person(s) authorized for pick-up. *

Submit

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