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FBC Richland | 2019 Sports & Art Camp Registration Form

June 24 - 28 | 6:30-8:30 pm

K5-6th Grade (Completed)

FREE!

Please complete one form for each child.

Child Information:

Child's Name:

Birth Date:

Grade Just COMPLETED:

Please list any allergies:

Pick your top 3 choices for sports that you would like to particpate in. (1st, 2nd and 3rd Choices):

1st Choice:

2nd Choice:

3rd Choice:

No, you do NOT have my permission to use my child's picture in VBS videos and publicity.

Parent Information

First Name:

Last Name:

Street:

City:

State:

Postal Code:

Phone Number:

Email:

Emergency Contact Name and Phone Number:

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FBC Richland | 2019 Sports & Art Camp Registration Form

June 24 - 28 | 6:30-8:30 pm

K5-6th Grade (Completed)

FREE!

Please complete one form for each child.

Child's Name:

Birth Date:

Grade Just COMPLETED:

Please list any allergies:

Pick your top 3 choices for sports that you would like to particpate in. (1st, 2nd and 3rd Choices):

1st Choice:

2nd Choice:

3rd Choice:

No, you do NOT have my permission to use my child's picture in VBS videos and publicity.

First Name:

Last Name:

Street:

City:

State:

Postal Code:

Phone Number:

Email:

Emergency Contact Name and Phone Number: