Home / Children and Youth / Vacation Bible Camp 2022 – Food Truck PartyVacation Bible Camp 2022 – Food Truck PartyNumber of Children To Be Registered:*12345Child InformationChild's Full Name* First Middle Last Suffix Child's Entering Grade in August 2022* Pre-K4 Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th GradeChild's Birth Date* MM slash DD slash YYYY Child's Gender Male Female 2) Child's Full Name* First Middle Last Suffix 2) Child's Entering Grade in August 2022* Pre-K4 Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade2) Child's Birth Date* MM slash DD slash YYYY 2) Child's Gender Male Female 3) Child's Full Name* First Middle Last Suffix 3) Child's Entering Grade in August 2022* Pre-K4 Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade3) Child's Birth Date* MM slash DD slash YYYY 3) Child's Gender Male Female 4) Child's Full Name* First Middle Last Suffix 4) Child's Entering Grade in August 2022* Pre-K4 Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade4) Child's Birth Date* MM slash DD slash YYYY 4) Child's Gender Male Female 5) Child's Full Name* First Middle Last Suffix 5) Child's Entering Grade in August 2022* Pre-K4 Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade5) Child's Birth Date* MM slash DD slash YYYY 5) Child's Gender Male Female Camp Registration for One $100* Price: Camp Registration for Two $200* Price: Camp Registration for Three $300* Price: Camp Registration for Four $400* Price: Camp Registration for Five $500* Price: If you have a special request to have your child in the same group as another registered camper of the same age, please list your child's first and last name and the other child's first and last name here. We will do our best to accommodate the request, but do not guarantee that they will be placed together.Parent or Guardian Contact InformationParent's/Guardian's Name* First Last Church Membership* Member of Gables UCC Member of Another Church NoneIf another church, please enter the name of your church below.*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work Phone*Cell Phone*Email* Secondary Contact (If unable to reach, please contact:)Name* First Last Phone*Name of Person(s) Authorized to Pick Up Child1) Name First Last 2) Name First Last Medical InformationChild's Physician's Name:* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Phone*Any medical concerns of which we should be aware?* Yes NoPlease List*Any Allergies/Dietary Restrictions?* Yes NoPlease List*Name of Health Insurance Company*Policy Number*Medical Treatment Consent* I authorize medical treatment for my child in case of accident or illness, if parent cannot be located or in an emergency.Cancellation Policy: This camp is non-refundable and non-transferable.Parent's/Guardian's Digital Signature*Today's Date* MM slash DD slash YYYY Subtotal Options Total Buy now Category: Children and Youth Product ID: 2566
