JAM Camp Registration

July 14th-18th
9:00 a.m. to Noon

Jam Camp Concert
Sunday, July 20th at 6:00 p.m.

ENROLLMENT OPEN TO CHILDREN ENTERING
1ST THROUGH 6TH GRADES
Deadline to enroll is June 15th.

 

Please complete a separate form for each child attending.

 

Child's Information

Name: first last

Birthday: Grade Completed: Choose One Not Started Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Primary Address:

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Father's Information

Name: first last

Address (if different):

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Home Phone: Work Phone:

Cell Phone:

Mother's Information

Name: first last

Address (if different):

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Home Phone: Work Phone:

Cell Phone:

Parent's Email Address:

JAM CAMP Specific Information

Who is allowed to pick up your child? (specify at least one)

1. 2. 3. 4.

Emergency Contact: Phone:

Child's Allergies:

Major Medical Conditions:

Is your child enrolled in Sunday School? Choose One Yes No

If yes, church name:

REGISTRATION FEE OF $10.00 IS REQUIRED
$10.00 Fee includes JAM Camp Theme Shirt and Field Trip

Shirt Size

Youth S M L XL

Adult S M L XL

XXL XXXL

I understand that by submitting this registration form I am committing my child to
attend both JAM Camp, July 14-18, 2008, and the JAM Camp Concert on July 20, 2008.

 

 

Washington Avenue Baptist Church © 2006