Camp EPIC
Fill out one form per child.

July 31st - August 2nd 6-8pm
Family After Party August 2nd 8-9pm
For kids entering K-6th grade
Cost - $10

Please note that when participating in LifePoint activities, photos or videos may be taken by LifePoint staff or volunteers. These may be used in-house or for basic promotional materials. Please contact rplattner@lifepointqcy.org for questions or if you need to opt out.

Email address *
Child's Full Name *
Your answer
Child's Birthday *
MM
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DD
/
YYYY
Allergies/Medical information that we need to know *
Your answer
Grade child is entering *
Child's t-shirt size *
Activity Choice for Wednesday *
Activity Choice for Thursday *
Activity Choice for Friday *
Guardian 1 Name *
Your answer
Guardian 1 Phone Number *
Your answer
Guardian 1 Email *
Your answer
Guardian 1 Address
Your answer
Guardian 2 Name
Your answer
Guardian 2 Phone Number
Your answer
Guardian 2 Email
Your answer
Guardian 2 Address
Your answer
Would you and/or your spouse be willing to help? (activities, check-in, helper, etc.) *
If yes what is your t-shirt size?
If your spouse is a yes - t-shirt size?
Cost is $10 per kid. You may pay in cash or online. For online payments 2.3% + $0.30 is subtracted for each donation. https://lifepointqcy.churchcenter.com/giving/to/camp-epic-lifepoint-kids *
A copy of your responses will be emailed to the address you provided.
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