Youth Dorm Registration 2017
Youth's Name
Your answer
Date of Birth
Your answer
Grade just completed
Your answer
Parent/Guardian
Your answer
Address
Your answer
Primary Phone #
Your answer
Secondary Phone #
Your answer
Email
Your answer
When should we expect your youth to arrive to Campmeeting?
Required
When will your youth be leaving Campmeeting?
My youth may:
Required
My child has the following allergies, special conditions, restrictions, or medication requirements:
Your answer
In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by Lake Arthur Camp to hospitalize, secure proper treatment for, and order injections, anesthesia, or surgery for my child. (Initial below to authorize.)
Your answer
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