Kids’ Camp 2016: 4 yr old Registration If you are human, leave this field blank.Sign-up: 4 year old group4 year old groupThe 4 year old group is for children entering Kindergarten in the Fall of 2017. Photo Release:Photographs/video recordings may be taken of programs and events. This registration constitutes your permission for Knox Church to use & publish your child\’s picture, in the event your child’s image appears in photographs/video recordings for any lawful purpose, including publicity, illustration, and web content. Medical Release:We take precautions to ensure your child\’s safety. Your registration constitutes your permission for Knox Church to administer first aid in the event your child’s injury (and call you at provided emergency contact number). Other adults permitted to pick up your child:Please note any adults that you authorize to pick up your child during the Kids\' Camp week.Adult's InformationAdult completing registrationFirst and last name of parent/ guardian registering child(ren)EmailEmail address of the parent/guardian registering child(ren)Phone numberIn case of emergency, phone number to contact you during Kids\' CampAddressPlease provide your street address, city, state, zipInvited?Were you invited to Kids' Camp by a friend?YesNoName of FriendChild 1 InformationName of CHILD 1:First and last name of childBirthdateday / month / yearAny allergies or special needs?YesNoDescribe any applicable allergies or special needsNote: Children\'s food allergies are noted on their name tags. Behavioral concerns are not publicly shared.Another 4 year old childAnother child to sign-up for the 4 year old group?YesNoChild 2 InformationName of CHILD 2First and last name of childBirthdate of CHILD 2day / month / yearAny allergies or special needs? CHILD 2YesNoDescribe any applicable allergies or special needs. CHILD 2Note: Children\'s food allergies are noted on their name tags. Behavioral concerns are not publicly shared.InstructionsAfter submitting this form return to the Kids’ Camp 2016 Registration page . To sign-up another child: Return to STEP 1 Sign-up If done signing-up child(ren): Continue to STEP 2 Payment PasswordPasswordCaptcha *reCAPTCHA is required.Submit
