Vacation Bible School July 24 - 29, 2017: RISE ABOVE THE STORM - NOAH'S ARK STORY
We are excited to provide “RISE ABOVE THE STORM” - NOAH'S ARK STORY. This year we want to provide your kids with a biblical perspective and a scientific approach to the world as we know it today.

Please, complete this form to register your child for a fun and spiritual summer camp experience, filled with games, crafts, music, outdoor sports, Bible study, snacks and more, July 24 - 29, 2017, from 9:00 am to 12:00 pm, at Elgin Adventist Church, 1141 Bode Rd, Elgin, IL 60120.

Use one entry for each child you register. Children 5-13 are welcome (must be potty trained). Older children and parents may serve as volunteer.

For additional questions, please leave a message for Stephanie (847)-697-0096 or better email her

Camper's first and last name
Your answer
Camper's address
Street, City & Zip
Your answer
Camper's gender
Camper's date of birth
Your answer
Camper's age
Camper's school grade
Does the camper have any allergies?
We cannot accept a child who will need medication administered during camp hours, unless a guardian is present at all times.
Does the camper have any physical limitations we need to know about?
Kids are expected to engage in physical activities each day, i.e. basketball, soccer, volley ball and other. Type NONE if no physical limitations.
Your answer
Parent's name
Your answer
Parent's phone
Your answer
Parent's email
Your answer
Parent's address
If different from student address. Type SAME if not different.
Your answer

Emergency contact
Type the name of the person who will provide transportation to the camper, if DIFFERENT than the above registered parent or guardian. Type SAME if same as parent or guardian.
Your answer
Emergency contact's relationship with camper
Your answer
Emergency contact phone
Type SAME if same as of parent or guardian.
Your answer
If different than parent or guardian. If it is the same person type SAME.
Pickup person's name
Your answer
Pickup person's phone
Your answer
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