2018 Preschool Camp Registration
 
2018 Preschool Camp Registration
Child #1: Last Name  * 
Child #1: First Name  * 
Child #1: Age  * 
Child #1 Birthday (MM/DD/YYYY)  * 
Child #1: Completed Grade  * 
Child #1: Attending GAME ON camp (June 18-22)?  * 
Child #1: Attending SHIPWRECKED camp (July 23-27)?  * 
Child #1: Special Concerns (Allergies, Medical Conditions, etc.)  * 
Child #2: Last Name
Child #2: First Name
Child #2: Age
Child #2 Birthday (MM/DD/YYYY)
Child #2: Completed Grade  * 
Child #2: Attending GAME ON camp (June 18-22)?  * 
Child #2: Attending SHIPWRECKED camp (July 23-27)?  * 
Child #2: Special Concerns (Allergies, Medical Conditions, etc.)
Child #3: Last Name
Child #3: First Name
Child #3: Age
Child #3 Birthday (MM/DD/YYYY)
Child #3: Completed Grade  * 
Child #3: Attending GAME ON camp (June 18-22)?  * 
Child #3: Attending SHIPWRECKED camp (July 23-27)?  * 
Child #3: Special Concerns (Allergies, Medical Conditions, etc.)
Parent #1: Last Name  * 
Parent #1: First Name  * 
Parent #2: Last Name
Parent #2: First Name
Street Address  * 
City  * 
Zip  * 
Your Email Address  * 
Home Phone (xxx-xxx-xxxx)  * 
Parent #1: Cell Phone (xxx-xxx-xxxx)  * 
Parent #2: Cell Phone (xxx-xxx-xxxx)
Emergency Contact (Name and Phone Number)  * 
Parent's Primary Insurance Company  * 
Insurance Group Number  * 
Church Attended, If Any
Interested in news about MVBC Children's Ministries and events?
Total $
 
 
Powered by eGiving by NCS Services