Jr High Summer Camp RegistrationIf you’ve already sent in a check and need to fill out your camper’s registration form, you’re in the right spot! Please remember that each child needs their own completed form. Parent Name * First Name Last Name Parent Name First Name Last Name Camper's Name * First Name Last Name Which camp did you submit payment for? * Jr High 1 - June 11th - 16th, 2023 Camper's Age * Grade Completed before coming to camp * Gender Male Female Camper's Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent's Email * Parent's Phone * (###) ### #### Camper would like to be in a cabin with: Any friends coming to camp? We will do our best to put them together. Camper T-Shirt Size * Youth Small Youth Medium Youth Large Youth Extra Large Adult Small Adult Medium Adult Large Adult Extra Large Medical Information & Release * I hereby authorize the staff and directors of LifeChange Camp to act in an emergency in the best interest of the health and welfare of my child during camp activities. Emergency Contact Name * In the case that the parents cannot be reached. First Name Last Name Emergency Contact Phone Number * In the case that the parents cannot be reached. (###) ### #### Home Church/Church Affiliation Home Church Address Allergies - Food Please list any foods the camper is allergic to AND the reactions AND the severity of those reactions. Allergies - Drug Please list any medicines the camper is allergic to AND the reactions AND the severity of those reactions. Other Medical Concerns Please list any medical conditions we need to be aware of to properly care for your child. Medications the Camper will take during camp Please list the names of medications, dosages, and time or times of day to be taken. Did anyone refer you to LifeChange Camp? I also authorize the use of any photos/ videos/ media including my child to be taken and/or used in camp material. * Yes No LifeChange Camp Policies * I have read and agree to the policies regarding my child's attendance at LifeChange Camp Thanks, your Camper Registration has been submitted! If you need to complete another form for another Jr High camper, just hit refresh on this page.
