2019 Kids Camp Registration
July 8 - 12, 2019 :: 6:00pm - 8:30pm
Dinner will be provided at 5:30pm.

PreK - 6th grade (PreK - must be 4-years old by July 1st)
HighPoint City Church; 4187 Landon Ave., SW; Iowa City, IA. 52240
Contact us at (319) 354-3026 or office@highpointcity.church

One form per child. Please register each child separately.
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Parents/Guardians First and Last Name *
Parents/Guardians Cell Phone &/or Home Phone *
Parents/Guardians Address *
Home Church *
Will parents/guardians be helping at Summer Kids Camp? *
Child's First and Last Name *
Child's Gender *
Child's Age *
Child's Last School Grade Completed *
Required
What days will you attend? *
Required
Dietary Restrictions
Allergies (including specific foods) or other Medical Condition *
In case of emergency please contact - First and Last Name *
 Emergency Contact Phone *
 Emergency Contact Relationship to Child *
The following adult(s) have my permission to pick up my child from Kids Camp - list all that apply.  (First and Last Name) *
I give permission for my child's photos or video clips to be used during Summer Kids Camp for slide shows, photo collages, or videos. (Photos & video clips will only be used during Camp at HighPoint City Church). *
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