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Game On

Summer Camp

Online Registration Form

Please fill out one for each child




Child's Name:
Parent/Guardian Name
Zip code
Home Phone:
Cell Phone
Work Phone
Email Address:
Child's Birth Date
Last Grade Completed
Are You Currently Attending a Church Yes
If Yes, where do you attend?
Medical or other information we need to know. Please include any allergies.
How did you hear about our camp?
In the event of an emergency, who may we contact: Name/phone
Who is authorized to pick up your child...please list all authorized persons. Id will be required to release your child.

By registering your child, I give the YMCA, Here's Hope Church, St. Anne's Church, and Park Methodist Church permission to use my child's unidentified photos.

Put a website form like this on your site.