Summer Camp Participant Application 2019
Hello and welcome! Apply here for Hope Reins' 2019 Summer Camp, where we will be focusing on the Beatitudes that are found in Matthew 5.
Which week of summer camp would you like your child to attend?
Participant Information
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age During Camp Week *
Your answer
Gender
T-Shirt Size *
Is your child currently in sessions at Hope Reins? *
Parent or Guardian First Name *
Your answer
Parent or Guardian Last Name *
Your answer
Is the above adult the child/teen's legal guardian? *
Best Contact Number *
Your answer
Email *
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
County
Your answer
Zip/Postal Code
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Phone *
Your answer
Participant Description
This section will help us have a better understanding of how we may best serve the child or teen
Child/Teen currently struggles with: *
Required
Has your child been to Hope Reins Summer Camp before? If so, how long have they been attending?
Your answer
Please include any allergies your child may have, as well as any mental/physical or developmental limitations that we should know about. *
Your answer
Please share anything you feel would be helpful for us to know in understanding and serving your child/teen better.
Your answer
Please indicate if you are applying for a scholarship for camp (only eligible if child is currently being served by Hope Reins) *
For scholarship applicants only* How would your family benefit by receiving a camp scholarship at Hope Reins?
Your answer
Thank you so much for filling out the application! You will receive a confirmation email once your application is processed.
If you have any questions please email brooklyn@hopereins.org
Submit
Never submit passwords through Google Forms.
This form was created inside of Hope Reins. Report Abuse - Terms of Service