Children's Ministry

Children's Ministry Hands Resized.jpg

MEGA SPORTS CAMP REGISTRATION

Name of Parent/Guardian *
First Name
Middle
Last Name
Home Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Phone:*
First Child's Name *
First Name
Middle
Last Name
Age*
Grade (Entering) *
Gender *
Please Choose One *
Please list any allergies and/or medical concerns
Second Child's Name
First Name
Middle
Last Name
Age
Grade (Entering)
Gender
Please choose one
Please list any allergies and/or medical concerns
Third Child's Name
First Name
Middle
Last Name
Age
Grade (Entering)
Gender
Please choose one
Please list any allergies and/or medical concerns
Emergency Contact Name and Number *
Emergency Contact Name and Number
I hereby grant permission for photo/video images to be taken of my child/children and used in Locust Grove Mennonite Church publicity materials, including but not limited to website, brochures, newsletters and public presentations.*
Medical Consent: In the event of an emergency, when the parent/guardian cannot be reached, i authorize the staff at Locust Grove Mega Sports Camp to exercise their best judgment in the care of my child. *