VBS/Day Camp Registration Form
Please fill out a separate registration form for each child.
Which VBS are you Registering for?
*
Hobson
Buffalo
Winnett
Day Camp (At Camp Lewtana near Lewistown)
Additional Information to Know:
A daily offering will be taken to support the Children's Hunger Fund. Children are encouraged to bring money to help provide meals for children around the world. On Friday at 2:30 p.m. there will be a program at the Camp. This is a very important part of Day Camp. Please make every effort for you and your child/children to be there. If you are unable to make it to the program, campers without a ride will be transported back to town one hour later than normal pick-up times.
Choose a location where we can meet you to bus your child to VBS. Please write down the pick-up times.
Garfield School (Pickup: 8:25 am/Return: 3:05 pm)
Highland Park School (Pickup: 8:30 am/Return 3:00 pm)
Civic Center (Pickup: 8:40 am/Return 2:50 pm)
Lewis & Clark School (Pickup: 8:45 am/Return 2:45 pm)
I will drive my child out to Camp each day
Name of Child
*
First Name
Last Name
Age
*
Grade in Fall
*
Address
*
Address
Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 1
*
First Name
Last Name
Parent/Guardian 2
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Church Affiliation?
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Health Information & Agreement
If parent cannot be reached in an emergency, contact:
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Child's Lewistown Doctor (if applicable)
Is child on medication?
*
Yes
No
Please list allergies, if any:
Personal Insurance Provider
*
Policy Number
*
Parent/Guardian Signature
*
Clear
For coupon code--tell us who you invited to Day Camp in the box below.
Submit
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