Children’s Music Camp August 5-9, 9:00 am – 12:00 noon

Registration 2019

Child's Name

Parent(s)/Guardian(s)' Names


City, State, Zip Code

Date of Birth

Grade Just Completed

Home Phone

Parent Cell Phone

Parent Email

Attend what church

List all allergies (if none, put "none")

List Major Illnesses (if none, put "none")

List Regular Medications

Emergency Contact #1


Emergency Contact #2


Who will pick up child

Photo consent: Crowfield Baptist Church has my permission to publish any pictures that the above named child might appear in on their website, in power point presentations, or in their newsletter or other church publications.
AcceptDon't accept

T-Shirt Size:
Youth Small (6-8)Youth Medium (10-12)Youth Large (14-16)Adult Small (34-36)Adult Medium (38-40)Adult Large (42-44)Adult X-Large (46-48)Adult 2X-Large (50-52)

Comments or questions