Registration Information: To register, fill out this paper, print, sign and.return.
Please be sure that you Type or Print neatly. Bring or Mail early registrations to church office:
Pastor Jason Losier
Grace Bible Camp Registration
128 Bradenville School Road
Bradenville, PA 15620-1023
Or call:
(724) 537-2840 (church office) (724)459-8203 (Camp)
The cost of camp is a $50 donation or as the Lord lays it on your heart.
Make checks payable to "Grace Bible Camp"
Can your child swim? (We will test all children on the first day of camp regardless of your answer, but we would like to have written permission from you saying that your child can perform in a 9 foot pool.)
List all allergies, medical problems, medications being taken, or other pertinent information that the nurse might need: (attach additional pages if needed)
I (we) understand that, in the event medical treatment is needed, every effort will be made to contact me. However, if I cannot be reached, I give my permission to the staff or sponsor to secure the services of a licensed physician to provide the care necessary including anesthesia, for my child's well being. Also, I have listed, to the best of my abilities and knowledge, all allergies and other formation that would be crucial to my child's well being.
Email address:
Parent/Guardian Name(s):
Signed ______________________________________ Date ______________
(Parent or Guardian Signature) (Mo, day, yr.)
Please type your information in the form, then print, and send (mail or fax) or bring a copy with you.
We must have a signed copy for our records.
You may assist us in early preparation by clicking the submit when finished.
