Kids' Camp 24': Camper Registration Form

Fill-out one form per camper.

Child's Info

Name

Gender

Female Male

Last Grade Completed

3rd 4th 5th 6th

T-Shirt Size

Any Food Allergies?

Parent/Guardian Info

Parent/Guardian Name

Phone

This address will receive a confirmation email

Address

Acknowlegement

[READ & ACKNOWLEDGE] You must pay the $180 registration fee below or opt to pay in the church office and complete the online medical release form by Thursday, June 6th, 2024, to secure your child's spot at camp. A link to the medical release form will appear on the confirmation page after completing this registration form and will be sent to your email upon completing this registration form.

I read and understand the statement above.

Yes

Payment

Pay Now or Later in the Church Office?

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

When?: Sunday, June 16 - Thursday, June 20, 2024

Who?: Kids' Camp is for kids who will have just completed 3rd Grade - 6th Grade. (6th Graders usually attend Student Life camp with Pastor Casey, but they are also welcome to register for this camp.)

Where?: Lake Sallateeska Baptist Camp, Pinckneyville, IL

How Much?: The cost is $180* per child and can be paid on this form or at the church office by Thursday, June 6th, 2024**, to secure their spot at camp. This price includes transportation, lodging, meals, camp activities, and a T-shirt.

*Scholarships are available but are limited. They will be awarded on a first-come-first-serve basis. Please get in touch with Pastor Ryan for scholarship info: 217-343-2964 -or- ryan@ibcbenton.com.*

Kids' Camp 24': Camper Registration Form

Description

Please Fix the Following