Enrollment form
"Breakout" - Spring Bible Day Camp 4.3.2020 - 1:30 pm check-in time, concludes at 4:45pm, potluck dinner follows
Email address *
Child's first name *
Your answer
Child's last name *
Your answer
Child's age *
Required
Parent/Guardian name (Last, First) *
Your answer
Email *
Your answer
Street address *
Your answer
City, State, Zip *
Your answer
Cell phone number *
Your answer
Emergency contact name & phone *
Your answer
Does your child have allergies? *
Your answer
Do you give permission to include your child in photographs which may be used on our Facebook page and website? (the identities of the children will not be included) *
Church your family attends *
Your answer
A copy of your responses will be emailed to the address you provided.
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