Summer Camp Registration

Thank you for registering your child for Souderton Mennonite Church's Kid Connections Summer Camp! Please fill out a separate registration for each child.

Please Select the camp(s) you are registering for your child * Worship Workshop July 10-13 9-11:30am. Completed 1st-5th grades Sports Camp June 26-29. Completed 1st-5th grades. Vacation Bible School August 7-10 6-8:30pm. Age 4 to completed 5th grade. **
** If you are registering for Vacation Bible School, please select your child's t-shirt size. Child Small Child Medium Child Large Adult Small
Child's Name * First Last
Birth Date * / MM / DD YYYY
Last Grade Completed
4 years old Entering Kindergarten in the Fall Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade
Parent/Guardian Name *
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Check One Home Phone Cell Phone
- (###) - ### ####
Email
Home Church
Allergies/Dietary Restrictions
Medical Concerns:
ALL children must be picked up each day by an authorized adult. Please list 2 -4 persons authorized to pickup your child. This person will be asked to show identification daily.
Authorized Person
Authorized Person
Authorized Person
Emergency Contact Information during Kid Connections Camp *
Photo/Video Release: All Camps will be photographed and videoed. Pictures and Video taken during this event may be displayed on social media (i.e. Facebook), SMC’s website, in SMC publications, etc.
By signing up your child, you give Souderton Mennonite Church permission to use his or her picture in Souderton Mennonite Church publications, website, Facebook page or however Souderton Mennonite Church sees fit. Children will not be identified by name.
Signature *