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Elements Registration
3RD - 6TH GRADE
Event Timing:
July 19th - 23rd
Event Address:
Penn Grove Retreat
6419 Pamadeva Rd
Hanover PA, 17331
Contact us!
pastor@communityefc.com
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Phone number that can be contacted during the day and evening
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Parent/Guardian Information
Parent/Guardian's Full Name(s)
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Address
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Medical Information (Insurance Company, Policy #)
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Your answer
My child has allergies, medication, or limitations that will discuss at registration
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Yes
No
If my child is injured at camp, at church, or in a church related activity or needs medical assistance, I give permission for treatment, understanding I will be notified at the earliest moment practical. Parent Signature:
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