Camper Information

Camper's Name

Date of Birth

Gender

Male
Female

Grade entering in Fall 2024:

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Church Attending:

Camper Lives with:

Address

Who will be picking up your child at the end of camp?

Campers in grades K-8th grades must be signed out by an authorized adult at the end of the week.

Name

Relationship to Camper:

If there are any persons NOT ALLOWED to pick up OR visit your child, please list name(s) and relationship(s).

Guardian Information

When and where appropriate, please type "N/A" (not applicable) in appropriate box and use zeros for that phone number. Thank you!

Mother's Name

Mother's Phone Number

Father's Name

Father's Phone Number

Legal Guardian's Name [leave blank if same as parent]

Legal Guardian's Phone Number (leave blank if same as parent)

Address

Event Registration Software by RegFox

4th & 5th CAMP

Camper Information

Who will be picking up your child at the end of camp?

Guardian Information