CentriKid Camper Registration
CentriKid Dates, July 15-19, 2019 - SBU, Bolivar, MO - Cost: $303
* Required
Camper's First Name
*
Your answer
Camper's Last Name
*
Your answer
Current Grade
*
3rd
4th
5th
6th
Birthday
*
mm/dd/yyyy
Your answer
Gender
*
Male
Female
Summer 2019 T-Shirt Size
*
YS
YM
YL
YXL / AS
AM
AL
AXL
Parent / Guardian's Name
*
Your answer
Home Address
*
Your answer
Parent Phone
*
Your answer
Parent Email
*
Your answer
Has your child made a Salvation decision?
*
Yes
No
Has your child been baptized?
*
Yes
No
I understand I may pay in full any time prior to the parent / camper's meeting on June 19 but that final payment must be made by that date. Payments can be made online at
https://goo.gl/8tavXq
or by check made out to Parkway Baptist Church.
*
Yes
No
I agree to attend the MANDATORY parent / camper's meeting on Wednesday, June 19 at 6:30 p.m. and have all forms completed by the end of that meeting.
*
Yes
No
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