Christian Camp Registration

Thursday, November 15, 2018
Christian Camp Registration
Camper's Information
Name
Sena Sweetland
Gender
Item - Christian Camp Registration Image-1 0
Female
Home Phone
(86) 8918201
Address
33 Brentwood Way
Richmo, Virginia, 23277
Emergency Contact Name
Ardyce Gumbley
Emergency Number
(19) 2765838
Emergency Number #2
(19) 2765838
Birth Date
Monday, March 5, 5607
Year of Graduation
Item - Christian Camp Registration Image-1 1
1981
Grade entering in the fall
Item - Christian Camp Registration Image-1 2
7th
Cabin Buddy
Cabin Buddy #1
Donec vitae n
Cabin Buddy #2
Donec vitae n
Parent or Legal Guardian Information
Parent/Legal Guardian
Sena Sweetland
Relation
Nullam
Work Phone
(15) 8189870
Cell Phone
(19) 2765838
Parent /Legal Guardian 2
Sena Sweetland
Relation 2
Nullam
Work Phone 2
(19) 2765838
Cell Phone 2
(15) 8189870
Church Information
Church City
Nullam orc
Church you attend
Nullam
Church you are coming with (if any)
Done
Email Confirmation
Other Information
How did you hear about us?
Item - Christian Camp Registration Image-1 3
Web
First Time Camper? (If yes, subtract $25 from camper fee)
Item - Christian Camp Registration Image-1 4
Yes
Health Information
Is camper free from infectious desease or conditions?
Item - Christian Camp Registration Image-1 5
Yes
Are immunications up to date?
Item - Christian Camp Registration Image-1 6
6/13/2018
Date of last tetanus shot
5/25/2018
Any activity the camper should be restricted from?
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Any physical, mental or other condition that would require special attention or medication while at camp?
Ut tellus. Nulla ut erat id mauris vulputate elementum.
List any past medical treatment that would be helpful for us to know.
Ut tellus. Nulla ut erat id mauris vulputate elementum.
List any allergies (ex: bees,peanuts, dairy)
Duis consequat dui nec nisi volutpat eleifend. Donec ut dolor. Morbi vel lectus in quam fringilla rhoncus.
Any dietary needs that we should know about?
Ut tellus. Nulla ut erat id mauris vulputate elementum.
List all medications, both prescribed and over the counter, all medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.
Ut tellus. Nulla ut erat id mauris vulputate elementum.
Payment Information
Method of Payment
(Paypal or Credit Card)Registration Fee+Processing Fee
51.50 USD
Total
51.50 USD
Camper Release
Camper Release (List anyone, including parents, to whom your camper can be released)
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Signature
Item - signature 7
About this template

Intended for camp coordinators with the mission of bringing youth closer to their church, this Christian Camp Registration PDF Template is the perfect tool for managing data. With registration data automatically converted into PDFs camp counselors can easily access, you’ll be able to devote more time to scheduling team-building and worship activities.

This customizable template includes form fields for campers to provide personal and guardian information, church affiliation, medical history, payment details, and authorized release. Jotform’s PDF Editor gives you the option to rearrange the template layout and attach your camp’s logo with our intuitive drag-and-drop editor. Once finalized, your personalized template will save campers’ registration forms as protected PDFs you can actually have faith in.


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