Church Camp Permission Form
Register your child for church camp and provide essential permissions for participation and transportation. Please complete all fields accurately.
Participant Full Name
*
First Name
Last Name
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participant Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Home Church or Congregation
*
Please Select
First Baptist Church
Grace Community Church
St. Mark's Lutheran
New Hope Assembly
Other
Select Camp Session/Attendance Date
*
Please Select
Session 1: June 8–12
Session 2: July 6–10
Session 3: August 3–7
Emergency Contact Full Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Transportation Permission
*
I authorize my child to be picked up and dropped off by church-approved transportation.
I will provide transportation for my child.
Submit Registration
Should be Empty: