Parent's Name *

First Name

Last Name

Parent's Phone Number *

(###)

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Age(s) *

Select the age(s) of your child(ren) attending Kids Camp.

Age 5

Age 6

Age 7

Age 8

Age 9

Age 10

Age 11

Age 12

Session Times *

Select day(s) your child(ren) will likely attend.

Monday, July 17, 3:30 p.m. - 5 p.m.

Tuesday, July 18, 3:30 p.m. - 5 p.m.

Wednesday, July 19, 3:30 p.m. - 5 p.m.

Thursday, July 20, 3:30 p.m. - 5 p.m.

Friday, July 21, 3:30 p.m. - 5 p.m.

Family Fun Day dinner, Friday, July 21, 5 p.m. - 6 p.m.

Pickup *

Is anyone other than a parent picking up the children at the end of any of the sessions?

No

Yes

Parent Name *

First Name

Last Name

Parent Phone Number *

(###)

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Kids Prayer Night Attendance *

Do you plan to bring your child(ren) to the upcoming Kids Prayer Night?

Yes

No

Kids Prayer Night Volunteer *

Would you be willing to serve during a future Kids Prayer Night?

Yes

No

Name *

First Name

Last Name