Summer Day Camps 2023 Registration

Child Information

Please complete one form for each child.

Child's Name

Address

Phone

*This number will be used in case of emergency.

This address will receive a confirmation email

*This email will be used for Camp communication.

Birthdate

*Please select your child's last completed grade at the time of camp. If your child completed 3-year-old preschool, please select, "No Grade." If your child completed 4K, please select, "Pre-Kindergarten."

Consent to Photography Use

*for congregational purposes

Medical Concerns/Allergies Yes

Explanation Information

Behavioral/Learning Concerns Yes

Additional Information

Parent Information

First Parent Name

First Parent Email (if different than above)

First Parent Phone (if different than above)

Second Parent Name

Second Parent Email

Second Parent Phone

Please indicate your church relationship

I would like more information about Good Shepherd Yes

How did you hear about summer camps at Good Shepherd?

Emergency Contact Information

Name

Mobile

Name

Mobile

Camp Information

Summer 2023 Day Camp Offering
Vacation Bible School (VBS) June 19-22, 9:00-11:30am, Age 3-Completed 2^nd grade, Verona Campus, $45 per child

Kinder Creation Camp July 17-19, 9:00-10:30am, Age3-Completed Kindergarten, Verona Campus, $35 per child

Camp Create It July 31-Aug 3, 9:00am-12:00pm, Completed Kindergarten-Completed 4^th grade, Verona Campus, $60 per child

Rise Up Nights: (1) June 27 (2) July 11 (3) August 15 6:00-7:30pm, Completed K-4^th grades, $10 per child/per night, Verona Campus

Summer Day Camps

VBS Kinder Creation Camp Camp Create It Rise Up Nights (1): June 27 Rise Up Nights (2): July 11 Rise Up Nights (3): August 15

For VBS only , please select t-shirt size

Suggest one friend of the same grade with whom your child would like to be placed

Payment Information

Please select the appropriate payment option for the camp you are attending.

VBS payment option

Kinder Creation Camp payment option

Camp Create It payment option

Rise Up Nights (1) June 27

Rise Up Night (2) July 11

Rise Up Night (3) August 15

Volunteer Opportunities

We cannot run our camps without the support of volunteers. Volunteer options include, snack servers, crew leaders, activity/lesson leader, technology support. If you are interested in helping make this a great summer for our kids please leave your contact information. We will contact you to make specific arrangements. Thank you!

Name

Your Email

Mobile

I consent that my child has permission to participate in camp activities, under supervision. Good Shepherd Lutheran church and its personnel will not be held responsible for accidents or personal injury arising there from.

Yes

Signature (Type Name)

*By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this registration form.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Summer Day Camps 2023 Registration

Description

Please Fix the Following