WCC Kids' Day Camp Registration
Event Timing: July 28, 2018 10:00am-12:30pm
Event Address: Westshore Christian Church | 3062 120th Ave., Holland, MI
Contact us at 616-399-2511
We require a separate registration for each child attending. Thank you!
Child Name (First and Last) *
Your answer
Child Age *
Your answer
Parent Info
Mother's Name (First and Last) *
Your answer
Mother's Phone Number *
Your answer
Father's Name (First and Last) *
Your answer
Father's Phone Number *
Your answer
Address *
Your answer
Contact Email *
Your answer
Emergency Contact Details
In the event of an emergency relating to your son/daughter please provide information below which we can use to contact you or a specified adult.
Adult Emergency Contact Name (First and Last) *
Your answer
Adult Emergency Contact Phone *
Your answer
Medical Information
Are there any medical conditions (i.e. allergies, epilepsy, asthma, diabetes, travel sickness etc.) which we should be aware of? *
Your answer
Please give any details of special dietary needs we should be aware of (e.g. food allergies) *
Your answer
Consent
My son/daughter may have his or her picture taken during the normal course of youth activities and those pictures may be used (without personal information) for future promotional materials or displayed on the church’s social media or website. *
Required
I agree to my son/daughter participating in the Children’s Day Camp and the bounce house run by Westshore Christian Church. I understand that every reasonable care will be taken to ensure the health, safety and welfare of my child. I realize and accept that in the event of my child’s behavior adversely affecting the safety of the activity, the organizers reserve the right to remove my child from activities until I can be contacted. *
Required
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