Camp Creation Registration: August 9, 10, 11- from 9AM until 12 Noon
St. John's United Church of Christ

Please fill out this form completely.
Registration is required by July 31

Cost for 1, 2, or 3 days is $15 (this price includes a t-shirt, supplies, and snacks)
If you are planning to attend only one or two days, the cost will remain at $15. Please indicate the days you are attending.

Transportation to and from all sites must be provided by parents, and parents/caregivers are welcome to stay with their children.

Thank you!

Child's First Name
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Child's Last Name
Your answer
Father's Email
Your answer
Mother's Email
Your answer
Child's Grade Level
Child's Birth Date
Your answer
Child's Allergies
Your answer
T-Shirt Size (indicate youth or adult and size)
Your answer
Father's Name
Your answer
Mother's Name
Your answer
Father's Phone Number
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Mother's Phone Number
Your answer
Father's Address
Your answer
Mother's Address
Your answer
Emergency Contact and Phone Number
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Additional Information
My child will be attending the following days:
Required
Your child may be photographed and those photos may be used in worship or for publicity purposes unless you specify that no photos be used.
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