Deaf Camp registration
Event Timing: July 16-22, 2017
Event Address: 1 Our Children's Highway, Alexander City, AL 35010
Contact us at (205)717-1111 or deafcamp2017@gmail.com
Email address *
Parent/guardian name *
Your answer
Relationship to the campers *
Home address street *
Your answer
Home address city, state & zip code *
Your answer
Home phone number
Your answer
Mobile number *
Your answer
Work number
Your answer
Email (if have more than one)
Your answer
Emergency contact person name: *
Your answer
Emergency contact relationship to the camper
Emergency contact person phone number: *
Your answer
Child's name *
Your answer
Child's gender *
Child's birthday *
MM
/
DD
/
YYYY
Child's grade in 2016-2017 school year *
Choose one or more of the following: *
Required
Shirt size *
Shirt size question 2 *
Shirt size (fund raiser only- no longer available)
Shirt size (fund raiser only- no longer available)
Shirt size question 2 (fund raiser only- no longer available)
Do we have permission to baptize? *
Required
Do we have permission to take pictures for our website and/or social media pages? *
Dietary restrictions/food allergy *
Please give a brief description of any medical or physical issues we need to know about. More details will be on the health form. *
Your answer
Does the camper have medical insurance? If yes, please bring the card or a copy of the card. *
Please give us the name of insurance and contract numbers. This is only to, be seen by administration team and if needed, hospital staff. This will also be asked on the health form. *
Your answer
I understand that if my child fails to obey the established rules, he/she will be asked to leave, and I will be responsible for arranging transportation for my child to return home. *
I understand that I will have to pay $50 for the family by Google wallet or by check, or money order to PO Box 6569 Talladega, AL 35161. *
Required
We provide transportation for anyone who has limited or no transportation. We will plan to have drop off points for anyone who needs it (to be announced on our website). Do you need transportation to and/or from camp? *
A copy of your responses will be emailed to the address you provided.
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