Email Address ------------------------------------------------------>

Name of child or children participating ---------------------->

2019 Day Camp Registration

Home Address & Two Phone Numbers -------------------->

We're excited to see you soon!

Where the Holy Bible is Wholly Taught

In this "Message" please provide the following info ----->

1) Parent/Guardian Name

2) Allergies/Medical Info (What type meds, reactions,                what time of day, what happens if not taken)

3) Child or Children Birth Day

4) Age

5) Grade Completed

6) Brought to Day Camp By Whom

7) Church you attend if any

8) Do you give permission to post your child's picture                 on our website?

9) Who will be picking up your child or children?