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Christ the King Lutheran Church Day Camp
August 6-10, 2018
8:30 a.m. -3:30 p.m.
Name *
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Grade in School Fall 2017-Spring 2018 *
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Mailing Address *
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Email Address *
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Guardian Name and Phone Number *
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Guardian Name and Phone Number
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Special Interest/Hobbies of Camper
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Any Restrictions to Physical Activity
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Any Allergies or Dietary restrictions
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Who can pick up Camper from Day Camp? (Name and Phone Number)
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Emergency Release: I will not hold Lutherhill Ministries or Christ the King Lutheran Church and their staffs responsible for accidents, claims and damages arising from my child’s participation in camp activities. I also give Lutherhill Ministries and Christ the King Lutheran Church permission to use any photograph/video of me or my child, taken at Day Camp for future promotional materials. *
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