Day Camp Enrollment Page
Please fill this card out in full and click the submit button at the bottom of the page.

General Information:

Child’s Name  

Parent/Guardian Name

 Address  

Phone Numbers:

Home
Work
Cell 

E–mail:

 Age Information:

Birth date (for preschoolers) 
                  or
Last grade completed in school  

 Medical Information:

Medical or other information we need to know (Please include any food allergies.)

Emergency Contact:

Name
Phone number 

Name
Phone number 

Dismissal Information:

Who may pick up your child at the end of each Day Camp Each day?

Other Information:

Do you attend Sunday School? If so where?  

T-shirt size