Karl Road Baptist Church

Growing Godly Generations

Day Camp Registration
  1. Please complete one form per child.
  2. Name of Child:(*)
    Invalid Input
  3. Grade Just Completed:(*)
    Invalid Input
  4. Birth Date:(*)
    Invalid Input
  5. Street Address:(*)
    Invalid Input
  6. City:(*)
    Invalid Input
  7. State:(*)
    Invalid Input
  8. Zip Code:(*)
    Invalid Input
  9. Home Phone:(*)
    Invalid Input
  10. Cell Phone:
    Invalid Input
  11. Email:(*)
    Invalid Input
  12. Parents Name:(*)
    Invalid Input
  13. Work Phone:
    Invalid Input
  14. Emergency Contact:(*)
    Invalid Input
  15. Phone Number:(*)
    Invalid Input
  16. Alergies or other Medical conditions:
    Invalid Input
  17. Name of Home Church:
    Invalid Input
  18. Name of Siblings attending VBS and grade completed:
    Invalid Input
  19. Name of person who will drop-off and pick up your child:(*)
    Invalid Input
  20. Phone Number:(*)
    Invalid Input
  21. Please type the letters below.
    Please type the letters below.
    Invalid Input