Day Camp Registration

Registrations forms due June 18th, suggested donation of $30 for 1st-5th, $25 for Preschool, Kindergarten
A bag lunch is needed every day – dress for weather. We will remain on site at CLLC for morning hours then there will be afternoon off site activities each day.

Schedule: Monday June 26 – Thursday June 29
9am – 11:30am for Kids who are Preschool Age: 3 year old (and potty trained) thru entering Kindergarten in the fall of 2017
9am – 3pm for Kids WHO WILL BE ENTERING 1st thru 6th grade in the fall of 2017

Thursday, June 29th - 6:30pm Program and Ice Cream Social, followed by Lock-in for 4th - 6th graders.

Please either mail your payment to: CLLC, Attn: Stacy Johnson, P.O. Box 175, Center City, MN 55012, or bring your payment to the potluck or first day of Day Camp.

Questions? Contact Stacy Johnson at 651-257-6300 or cllcchrised@frontier.net

Email address *
Parent/Guardian Name *
Your answer
Home Address: *
Your answer
Cell Phone # *
Your answer
Child's Name: *
Your answer
Age (children must have turned 3 by September 2017 and must be potty trained): *
Your answer
Grade in Fall of 2017: *
Your answer
Child's Name (if multiple children):
Your answer
Age (children must have turned 3 by September 2017 and must be potty trained):
Your answer
Grade in Fall of 2017:
Your answer
Child's Name (if multiple children):
Your answer
Age (children must have turned 3 by September 2017 and must be potty trained):
Your answer
Grade in Fall of 2017:
Your answer
Child's Name (if multiple children):
Your answer
Age (children must have turned 3 by September 2017 and must be potty trained):
Your answer
Grade in Fall of 2017:
Your answer
Who is authorized to pick up your child *
Your answer
Emergency Contact, Name: *
Your answer
Relationship to Child/ren: *
Your answer
Emergency Contact, Cell phone: *
Your answer
Any physical conditions requiring special care? please explain.
Your answer
Allergies or Special Concerns (please describe reaction and treatment) *
Your answer
Any activity restrictions?
Your answer
Home Church:
Your answer
Grades 4-6: Will your child be attending the Thursday evening Lock-in?
May we have permission to photograph your child? *
Would you be willing to provide extra cold lunches for the counselors? (3 lunches on one day)
Would you be willing to host the 3 counselors for Supper (Mon-Th.)
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