Limestone Bible Camp | Registration

Camper Registration

Session:
Name:
	First	Middle	Last
Name Preference:		Please enter the name your child prefers to be called.

Address:

	City	State	Zip
Birthdate:	//
Gender:
Grade:		Select the grade you will be entering this fall
School:
Church:
E-Mail:
Swimming:		Camper has permission to swim? (Yes or No)
Medical Information
History:
Allergies:
Medications:
Tetanus:
Insurance:
Policy Number:
Parent Information
Name:
Home Phone:
Employeer:
Work Phone:
Cell Phone:
E-Mail:
Mini camp:		Are you attending Mini Camp with your child?
Second Parent Information
Name:
Home Phone:
Employeer:
Work Phone:
Cell Phone:
E-Mail:
Mini camp:		Are you attending Mini Camp with your child?

Mini Camp

Starts In

Days

Full Camp

Starts In

Days