Peace Camp Online Registration
This is the participant registration form for Peace Camp at Old South United Methodist Church of Reading, MA. Camp runs Tuesday through Thursday, April 16-18, from 9am to 2pm. Volunteers (6th grade through adults) can sign up by emailing PastorCarol@oldsouthumc.org.
Parent Names *
(Or Guardian in charge during camp)
Your answer
Parent Phone 1 *
Best number to call if we need to reach someone during camp. Please include short description (ex: 781-315-0000 Mom's Cell)
Your answer
Parent Phone 2 *
Number to call if we can't reach Parent 1. (ex: 781-944-0000 Dad's Office)
Your answer
Home Address *
Please include town and zip code if outside Reading
Your answer
Email Address *
For correspondence before and during camp. This address will not be shared or used for any other purpose.
Your answer
Child 1 Name *
First and Last
Your answer
Child 1 Nickname
Preferred name to be called. For example, Victoria goes by Vicky. We'll put Vicky on her name tag.
Your answer
Child 1 Date of Birth *
MM
/
DD
/
YYYY
Child 1 Grade *
Child 1 Allergies or Special Concerns *
Food allergies, learning disabilities, sensory sensitivities, triggers, physical limitations, or anything else you would like us to know about your child. If none, write "none."
Your answer
Would Your Child Benefit from a "Break Room"?
We may provide a separate, sensory-sensitive space for children who get overwhelmed or may need a break from their peers or the structure of camp. Please let us know if you anticipate your child visiting the break room.
Do you have another child to register? *
***This is not the final question. Please hit the "Next" button after this question to continue.
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This form was created inside of Old South United Methodist Church.