Student's Name
Your answer
Parent's Names
Your answer
Parent Email Addresses
Your answer
Parent Phone Numbers
Your answer
Child's Birth Date
MM
/
DD
/
YYYY
Child's Current Grade Level
4th
5th
6th
7th
8th
Row 1
Has your child attended an overnight camp away from home in the past?
Will your child participate in fundraisers to decrease the cost to your family? (Note: only students participating in fundraisers will benefit from them)
Are you willing to serve as a chaperone if needed? (all your expenses are paid)
A full registration packet will be emailed to you. Contact Brent Bitter if you have any questions. Make your check payable to Grace Lutheran Church. Submit all completed forms and full payment to Grace by April 30th.
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