2018 Camp Grace Registration
Child's Name *
Birthday *
MM
/
DD
/
YYYY
Address *
School Grade (Fall 2018) *
To keep your child as safe as possible, please fill out the applicable information:
My child has the following conditions that may require medical intervention, please list condition followed by type of intervention necessary (epi pen, inhaler, etc.) *
My child has the following physical limitations *
Parent Contact Information
Parent #1: Name *
Parent #1: Phone *
Parent #2: Name
Parent #2: Phone
Emergency Contact Information
If parent is unavailable
Emergency: Name *
Emergency: Phone *
Hospital/Doctor Preference *
By participating in Camp Grace, you understand that photos of your child may be posted to our Facebook, Instagram, and/or website.

If you see any image of your child that you wish not to be used on one of these platforms, please contact grace@gracemahomet.org and let us know which photo you would like removed and we will take the photo down. Please include your name and contact info, so we can reach you if we have trouble locating the photo.
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