Down By The Creek Bank Music Camp 2016

August 1-5, 2016 - 10am-3pm

Rising 1st-6th Grade

Each child requires individual registration

Child's Name (First and Last) *

Parent/Guardian Name (First and Last) *

Address *

Mailing Address (if different)

Contact Information

Home Phone

Work Phone *

Mobile Phone *

Is it OK to text this number *

Yes

Emergency Contact #1 (Name and Telephone Number *

Emergency Contact #2 (Name and Telephone Number *

Email Address

Is it OK to send you updates regarding Beverly Hills Baptist ministries *

Yes

Age Information

Last Grade Completed in School *

Medical Information

Medical or other information we should know. (Please include food allergies.

Dismissal Information

Who may pick up your child from Music Camp? (Other than Parent/Guardian already listed) *

Other Information

Does your child attend church or Sunday School? If so, where? *

If your child or children are visiting Beverly Hills Baptist Church and are visiting with a friend, who are they a guest of?

May we have permission to photograph your child? *

Yes

May we have permission to use photographs of your child for the purpose of kids ministry promotion? *

Yes

If you live in the Spruce Hill neighborhood, will your child be riding the church transportation to and from the Spruce Hill neighborhood to Beverly Hills Baptist Church? *

Signature Required

Signature *

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