CBC Preschool
Tuesday, September 26, 2017
Kids In The Hands Of God
 

2013 Upward Camp Registration
(fill in every field)
Child's Name:                         
Parent/Guardian Name:           
Address:                               
Phone Numbers:
     Home:                              
     Work:                               
     Cell:                                 
Email Address:                       
Birthday:                                
Last Grade Completed:            
 
Medical Information
 
     Medical Info./Conditions (include allergies, etc.)
                                 
     Emergency Contacts (if different than above)
          Name:                         
          Phone:                        
          Relationship to child:    
 
Dismissal Information:
     List Names of those approved to pick up your child (other than the above):
          Person 1:
          Person 2:
          Person 3:
 
Church your family attends:    
 
If invited to attend by
someone at CBC, who:           
 
Child's T-Shirt Size:
     Youth X Small
     Youth Small
     Youth Medium
     Youth Large
     Adult Medium
     Adult Large
     Adult X Large
 
Note: Camp Fee is $30 per participant
Payment Options: (choose one)
     I will bring my payment by the church office
     I will mail in my payment to the church
                              mail to:  Cumming Baptist Church
                                    115 Church Street
                                    Cumming, GA 30040
     I will pay the camp fee using the online option
click here
to pay online
 
 
We will be taking pictures & video throughout the week. May we use your child's photo?
     Yes
     No
 
 
Comments:
           
 
Note:  You will receive confirmation of your registration once we receive your form and your payment.