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

    Registration 2019

    Child's Name

    Parent(s)/Guardian(s)' Names

    Address

    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

    Phone

    Emergency Contact #2

    Phone

    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