SOUTHTOWN SUMMER CAMP 2021

July 14-18 | SUMMER CAMP is happening at Southtown Baptist!

Wed, Thur, Fri 6-8:30 p.m. & Sat, Sun 10 a.m.-noon

Family Information

Parent/Guardian Name(s)

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Child's Name

*

Birthdate

*

Last Grade Completed in School

*

Please select one option.

PK K 1st 2nd 3rd 4th 5th

Medical Information

Allergies?

Please list any other medical or information we need to know (disabilities, behavioral issues, etc.)

Emergency Contact (other than parent/guardian listed above)

Emergency Contact Name

*

Emergency Contact Phone Number

*

Other Information

Do your children attend a church?

Please select all that apply.

Yes No

If so, where?

May we have permission to photograph your child?

*

Please select all that apply.

Yes No

If we can photograph your child, may we have permission to use your child's photograph for the purpose of promotion or on our church social media?

*

Please select all that apply.

Yes No

How did you hear about Summer Camp?

*

Please select one option.

Southtown Baptist Church Online/Social Media Local Outdoor Advertising Friend Other

Would you like to receive information about Southtown's Children's Ministry?

*

Please select all that apply.

Yes No

Description

July 14-18

SUMMER CAMP is happening at Southtown Baptist!

Wed, Thur, Fri 6-8:30 p.m. & Sat, Sun 10 a.m.-noon

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