2020 Messiah Summer Day Camp Registration
Thank you for registering for Messiah Summer Day Camp. Each family must complete one registration online form. The form will take about 10 minutes to complete and the following information will be required to submit. There is no option to save and return to the registration later.

-Parent Contact Information
-Three Emergency Contact's Information (Other than parents or guardians)
-Doctor Contact Information, Hospital Preferences, Insurance Information.
-Online Payment upon completion of registration.

If any required fields do not apply, simply state "N/A".

Once the form is submitted, you will receive a link to an online store. Please pay your registration fee immediately or save the link to pay within 7 days. If the payment is not received within 7 days, your registration will be cancelled. You will be notified of cancelled registrations via email only. All registration fees are nonrefundable. You will receive an emailed copy of this form and a receipt from square to show a confirmation of registration. Camp communication will begin two weeks before camp starts in May.

Please contact wpinkston@messiahnetwork.org for any questions or concerns.
Email address *
Guardian/Mother's First and Last Name *
Your answer
Guardian/Mother's Phone Number *
Your answer
Guardian/Mother's Email *
Your answer
Do you wish to include guardian/mother's email on the mailing list? *
Does guardian/mother have permission to pick up? *
Guardian/Father's First and Last Name *
Your answer
Guardian/ Father's Phone Number *
Your answer
Guardian/Father's Email *
Your answer
Do you wish to include guardian/father's email on the mailing list? *
Family Street Address *
Your answer
Family City *
Your answer
Family Zip Code *
Your answer
Who is financially responsible for this family's account? *
Family Church Home *
Your answer
How did you find out about camp? *
How often do you plan on using camp this summer? (This is just for planning purposes. No commitment is needed at this time.) *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy