CAMPER'S INFORMATION * First Name Last Name GENDER * Male Female SHIRT SIZE * XS S M L XL PANT SIZE * XS S M L XL DATE OF BIRTH * MM DD YYYY RISING GRADE * K 1st 2nd 3rd 4th 5th ADDRESS * Address 1 Address 2 City State/Province Zip/Postal Code Country HOME PHONE * (###) ### #### How did you hear about our program? * CHURCH AFFILIATION * Does your child have any allergies, special needs, or behavioral habits that we need to be aware of? If so, please explain. * PARENT/GUARDIAN INFORMATION * First Name Last Name CELL PHONE * (###) ### #### EMAIL * EMERGENCY CONTACT #1 * First Name Last Name PHONE * (###) ### #### RELATIONSHIP TO CAMPER * EMERGENCY CONTACT #2 * First Name Last Name PHONE * (###) ### #### RELATIONSHIP TO CAMPER * PICKUP AUTHORIZATION #1 * First Name Last Name PHONE * (###) ### #### RELATIONSHIP TO CAMPER * CONSENT The Camp Director will email you an invoice on how much to pay. You may use the next popup link to pay through PushPay (drop down Summer Camp). Thank you!
