JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Solid Rock Day Camp: Camper Registration Form
Host Church: St. John's Kittanning, PA, June 26-July 1, 2022
Please use this form to register your child for Solid Rock Day Camp, a ministry of the Carolinas Mission Region.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Parent/Guardian's Name:
*
Your answer
Parent/Guardian's Phone Number:
*
Please use the number you check most frequently.
Your answer
Parent/Guardian 2's Name:
Your answer
Parent/Guardian 2's Email:
Your answer
Parent/Guardian 2's Phone Number:
Your answer
Home Address:
*
If child has two home addresses, please use the address for the primary custodial parent/guardian.
Your answer
Emergency Contact Name (other than parents):
*
Your answer
Emergency Contact Number (other than parents):
*
Your answer
Do you give us permission to give your child(ren) basic first aid, including pain relievers?
*
Your answer
In dire emergency, do you give us permission to seek appropriate treatment for your child(ren)?
*
Yes
No
Is there anyone NOT authorized to pick up your child(ren)? (drop-off and pick-up will be monitored by an adult church volunteer)
*
Your answer
If off-site field trips are planned, transportation will be on church vehicles driven by adult church volunteers. Do you give permission for your child(ren) to go off-site for field trips? (contact your church Day Camp coordinator for more info)
*
Yes
No
Other:
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
