Kid’s Camp Registration

Kid’s Camp (Ages 8 – 5th Grade) Registration

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First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

(xxx) xxx-xxxx

Email *

(To receive confirmation of registration.)

Gender *

Date of Birth (XX/XX/XXXX) *

Grade Completed *

T-Shirt Size *

Home Church *

Parent/Guardian Name(s) *

Emergency Contact Person *

Emergency Contact Person's Phone *

I agree to allow my child to attend Kid's Camp 2022. I relinquish New Life Church, Word of Life, Life Source Church, ABBA’S Haven, volunteer workers and anyone associated therein of any liability. In case of an emergency, I give permission for my child to be taken to a hospital, or any other emergency facility, and give permission for a medical doctor or hospital to administer any treatment they deem necessary; I will assume full financial responsibility. I do this in faith that all parties involved will give close supervision during all activities and use wisdom with any decisions they will have to make. *

Medical / Personal Notes

Pay *

$150 Online Now

$150 Cash Later

You must click the "Submit" button on this page in order to complete your registration. Check your SPAM folder if you do not receive an email notification.