Crossroads Camp Treasure Island in Partnership with Child Evangelism Fellowship® --- Registration Form
Please fill out the form below to register your child. Camp Treasure Island will be held at Crossroads Community Church from July 23 to July 27, 2018. Please submit a separate form for each child to be registered.

Cost of the camp is $5 per child or $10 per family. (Scholarships are available as needed - please contact the church if money is an issue).

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Gender *
Child's Age *
Your answer
Child's Date of Birth *
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DD
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YYYY
Child's Grade in September *
Your answer
Child's School *
Your answer
Child's Home Address *
Your answer
City, State, Zip Code *
Your answer
Parent Name *
Your answer
Parent Email
Your answer
Emergency Name & Phone Number *
Your answer
Secondary Emergency Name & Phone Number *
Your answer
Siblings also attending CTI
Your answer
Medical Needs/Allergies/Special Needs
Your answer
Place of Worship You Attend (if any)
Your answer
DISMISSAL: At 12:00 Noon, My Child... *
Waiver
By Completing this registration form I agree to save and hold harmless Crossroads Community Church and its paid or volunteer staff from any injury sustained while participating in the Camp Treasure Island Program, and that my child is permitted to walk with their group to Cardington Recreation area for games.
Enter Parent/Guardian Name to Accept Waiver (Required) *
Your answer
OPTIONAL Photography and Video Release
Child Evangelism Fellowship® may, from time to time, document the activities of the ministry with photos or videos. I hereby assign and grant to Crossroads Community Church the unqualified right to ownership, use, and proceeds of all photographs of the child, without reservation or limitation, including use of photographs of the child for advertising and promotional purposes.
Enter Parent/Guardian Name if you Approve the Photography and Video Release
Your answer
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