2019 Hensel Camper Registration Form
Confirmations will be sent to email address listed below:
Email address *
Camper Information
Camper's Last Name *
Your answer
Camper's First Name *
Your answer
Camper's Gender *
Current Grade *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Home Congregation *
Your answer
Baptized *
T-Shirt Size (Select One) *
Shirts are included in the camp fee.
Parent or Guardian Contact Information
Father or Mother or Guardian Name *
Your answer
Father or Mother or Guardian Email Address
Your answer
Parent or Guardian Contact Number *
Your answer
Alternate Parent or Guardian Contact Number *
Your answer
Health Record
Please Check all Immunizations Received *
Required
Does your child have Asthma? *
If YES and they use a "rescue inhaler", please make sure they have it with them at all times during camp.
Do you have any medications or other conditions and/or restrictions that may require attention by the nurse or staff?
If your child needs to take any medications at camp, you will need to check them in with the camp nurse at Sunday’s check-in in the cafeteria
Your answer
List any known medical and/or food allergies and recommended treatments:
Your answer
Swim Questions
Has youth had swimming lessons? *
Is youth able to swim? *
Is youth allowed to swim with supervision? *
Parental swimming restrictions or other comments
Your answer
ACKNOWLEDGEMENT - Parent or Guardian acknowledges the purpose of this online pre-registration form is to secure your child's place at camp. Parent or Guardian further acknowledges the printed camper release form must be submitted along with payment to confirm your child's registration camp. The form is in the Hensel Camp Packet on the SW website. *
Parent or Guardian type in name to be used as signature *
Your answer
A copy of your responses will be emailed to the address you provided.
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