Solid Rock Day Camp: Camper Registration Form
Host Church: St. John's Kittanning, PA, June 26-July 1, 2022
Please use this form to register your child for Solid Rock Day Camp, a ministry of the Carolinas Mission Region.
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Email *
Parent/Guardian's Name: *
Parent/Guardian's Phone Number: *
Please use the number you check most frequently.
Parent/Guardian 2's Name:
Parent/Guardian 2's Email:
Parent/Guardian 2's Phone Number:
Home Address: *
If child has two home addresses, please use the address for the primary custodial parent/guardian.
Emergency Contact Name (other than parents): *
Emergency Contact Number (other than parents): *
Do you give us permission to give your child(ren) basic first aid, including pain relievers? *
In dire emergency, do you give us permission to seek appropriate treatment for your child(ren)? *
Is there anyone NOT authorized to pick up your child(ren)? (drop-off and pick-up will be monitored by an adult church volunteer) *
If off-site field trips are planned, transportation will be on church vehicles driven by adult church volunteers.  Do you give permission for your child(ren) to go off-site for field trips? (contact your church Day Camp coordinator for more info) *
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