Registration Form
Children's Music Camp
June 10-15, 2018
6:00-8:30 PM
Completed K-6th Grade
Cost: FREE! (SIGN UP BEFORE JUNE 7TH
TO RECEIVE A FREE T-SHIRT!)
Cleveland First Baptist Church
Cleveland, GA 30528
706-865-FBC3
CHILD'S NAME *
Your answer
PARENT/GUARDIAN NAME *
Your answer
ADDRESS *
Your answer
HOME PHONE *
Your answer
WORK PHONE *
Your answer
CELL PHONE *
Your answer
EMAIL *
Your answer
CHILD'S DATE OF BIRTH
MM
/
DD
/
YYYY
LAST GRADE COMPLETED IN SCHOOL *
MEDICAL OR OTHER INFORMATION WE NEED TO KNOW. (PLEASE INCLUDE FOOD ALLERGIES *
Your answer
EMERGENCY CONTACT NAME & NUMBER (OTHER THAN ABOVE) *
Your answer
EMERGENCY CONTACT NAME & NUMBER *
Your answer
WHO MAY PICK UP YOUR CHILD AT THE END OF EACH MUSIC CAMP DAY? *
Your answer
DO YOU ATTEND CHURCH? *
Required
IF SO WHERE?
Your answer
T-Shirt Size: *
MAY WE HAVE PERMISSION TO PHOTOGRAPH YOUR CHILD? *
Required
Submit
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