Bethel Karate Camp July 26th - 30th, 2021
This form is for Bethel Lutheran Church - Clearwater Summer Camp registration for 2021 year.
Please complete all pertinent sections of this form.
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Child 1 Name *
Child 1 Age *
Child 1 Date of Birth *
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/
DD
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YYYY
Child 1 Allergies *
Column 1
Nuts (Tree or other)
Gluten
Soy
Lactose/Milk
Medications
Insects (Bee, wasp, etc.)
No known allergies
Other...
Special Instructions/Additional Information (anything we need to be aware of regarding your child):
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