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

Day Camp [K-2nd]

Camper Information

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

Guardian Information