Register Online
download
consent
pdf form
download
registration
pdf form
Child's Name:
*
School:
Grade:
*
(2010-2011 School Year)
K
1
2
3
4
5
6
7
8
9
10
11
12
Date of Birth:
*
(mm/dd/yy)
Male
Female
Age:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
Mother's Name:
*
Mother's Work Phone:
*
Mother's Cell Phone:
Father's Name:
Father's Work Phone:
Father's Work Phone:
Address:
City:
Zip:
Email:
*
Emergency Contact Information
Name:
Relationship:
Tel:
Name:
Relationship:
Tel:
Sibling's Names:
T-Shirt Size:
Additional Shirts are $5.00 each.
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2X(+$1)
Adult 3X(+$2)
Cedar Grove United Methodist Church
Rainbow Park Baptist Church
Summer Camp
Afterschool Program
*Required Fields
