Kids Day Camp 2022

This event is Aug.1st - 5th from 5:30 p.m. - 8:00 p.m. (dinner will be provided.) This event is for children ages 4yr olds - 6th grade. This is a FREE EVENT! We will NOT be offering bus transportation this year.

Child's Full Name

Child 2 Full Name

Child 3 Full Name

Child's Address

Child's Date Of Birth

Child 2 Date of Birth

Child 3 Date of Birth

Grade Going Into

Child 2 Grade

Child 3 Grade

Phone Number

Parent or Legal Guardian

Parent or Legal Guardian Email Address

Emergency Contact Person Name

Emergency Contact Phone Number

Allergies (especially to food) SPECIFY WHICH CHILD

Other Helpful Info. (medication, activity restriction, etc.) SPECIFY WHICH CHILD

Would your child(ren) like a Kids Day Camp T- Shirt? Cost is $5 (Payment can be made during the week of camp.)

If yes, which sizes?

I grant permission to Emmanuel Christian Church to use my child's image for promotion and/or other purposes.

What church do you attend? (If you don't attend a church please put none.)

Email

example@example.com