Summer Bible Camp Registration

Harvest Kids Summer Bible Camp Online Registration Form

* Indicates required field

Chef's Name (Child) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian Name *

Email *

Cell Phone Number *

Date of Birth *

Home Phone Number *

Home Church *

Any Allergies? *

Has your child had Covid symptoms within the last 3 days? *

Yes No

Emergency Contact *

First

Last

Emergency Contact Phone Number *

List individuals authorized to pick up child *

By submitting this form, You giving permission to use your child's photograph publicly in Summer Bible Camp promotions. By submitting this registration you understand the images may be used in print publications, online publications, presentations, websites, and social media. You also understand that no royalty, fee, or other compensation shall become payable to you by reason of such use.

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