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Emmanuel Free Church Kids Fish Camp 2019 Registration Form
Camper's First Name
Camper's Last Name
Parent/Guardian Name (First & Last)
Parent/Guardian Phone Number
CHECK HERE IF PARENT/GUARDIAN IS STAYING TO PARTICIPATE IN FISH CAMP
I will be staying the entire time and participating with my child(ren). I will complete Sections 1 and 2 of this form and skip Secction 3.
PLEASE FILL OUT THE REST OF THIS FORM ONLY IF YOU ARE DROPPING OFF YOUR CHILD(REN) AND WILL NOT BE STAYING TO PARTICIPATE
I will NOT be staying with my child(ren) and will complete Sections 1, 2, and 3 of this form
Emergency Contact & Number (different than parent/guardian above)
In the event of an emergency, Emmanuel Free Church will first make every effort to contact the Parent/Guardian listed above before contacting the emergency contact.
Special Concerns (allergies, medications, medical conditions, etc)
List of any additional persons picking up your child
If Parent/Guardian listed above will not be picking up child on one or more days, please list approved alternate(s)
Electronic Signature for Section 1
By typing your FULL NAME you are stating that the above information is correct and that this is your legal, binding ELECTRONIC SIGNATURE
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