Fill Out Your Registration Form Below!

Registration Form

Which Camp are you registering for?

1st Childs Name

First Name

Last Name

Gender

Age

Allergies or Medical Concerns

Allergy or Medical Concern Description

Please describe if allergy or medical concern is selected

2nd Childs Name

First Name

Last Name

Gender

Age

Allergies or Medical Concerns

Allergy or Medical Concern Description

Please describe if allergy or medical concern is selected

3rd Childs Name

First Name

Last Name

Gender

Age

Allergies or Medical Concerns

Allergy or Medical Concern Description

Please describe if allergy or medical concern is selected

Additional Children

Please include: First & Last Name, Age, Gender, and if there are allergy or medical concerns.

Best Contact Name and Number

First Name

Last Name

Phone Number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Authorized to Pick-up

Need Transportation

Parent/Guardian Permission

By typing my name in the blank below I give permission for my child or children to participate in the 2024 Adventure Camp at Brownsburg Baptist Church, and authorize the adult leaders supervising this activity to administer emergency treatment to the above-named participant for any accident or illness and to act in my stead in approving necessary medical care.

https://buy.stripe.com/28oaF95zu8rWfo48wD for June 5th. Payment must be received before registration is valid.