Kids Camp Registration
Please fill out the questions below in order for your child to attend Kids Camp.
Name: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Grade entering this Fall: *
Parents Name(s): *
Your answer
Phone Number: *
Your answer
Address: *
Your answer
Email: *
Your answer
Is there anyone who CANNOT pick up your child: *
Your answer
Name(s) picking up child other than parent:
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Phone Number: *
Your answer
Allergies or Medical Conditions: *
Your answer
Special Instructions:
Your answer
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