2018HopeSummerCamp RegistrationForm (PDF)

HOPE
CHRISTIAN
SUMMER
CAMP
HOPE SUMMER CAMP REGISTRATION FORM
Camper’s Name:

Age:

Date of Birth:

Sex:

Address:

T-Shirt Size:

Apt. #:

Phone #:

City:

Allergies:

State:

Zip:

Current Medications:

Guardian #1 Name:

Guardian #2 Name:

Phone #:

Phone #:

Email Address:

Email Address:

AUTHORIZED PICK UP AND EMERGENCY CONTACT
At dismissal and/or in case of emergency the following people are authorized to pick up my child:
Guardian #1:

YES

NO

Guardian #1:

YES

NO

At least two additional authorized pickups 18 years old and older are required:
1.

Relation:

Phone #:

2.

Relation:

Phone #:

3.

Relation:

Phone #:

4.

Relation:

Phone #: