All Fields Required
MM/DD/YY
Last, first
Child's
Name
Date of
Birth
Grade September 2017
MM/DD/YY
Last, first
Child's
Name
Date of
Birth
Grade September 2017
Last, first
Date of
Birth
MM/DD/YY
Child's
Name
Grade September 2017
Address
Zip
Code
Phone
Number
City
State
Name of Parent/Guardian:
Emergency Phone # Parent/Guardian:
Allergies or medical information that we should be aware of
(Please state none if there is no information to report)
$ 5.00 fee per child
Please check box to confirm that fee will be
paid on the first day of camp, July 1
6, 2017.
Yes, I Agree
T Shirt Size (indicate size for one shirt per child, entering the number of shirts for that size.)
L
S
M
Child:
Adult
XL
S
L
M
XXL
We will perform for the congregation on Sunday, July 23rd,
during the morning worship service.
Following the service, a hot dog roast luncheon will be held,
and families are invited.
It is most important when assigning roles in the drama that we know who
will be able to attend on Sunday.
Number of persons
attending worship
I can be part of the Sunday Performance
Yes
No
I will attend the Hot Dog Roast luncheon
Number of persons
attending luncheon
Yes
No
Questions, comments, or feedback:
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