"Camp @ Church" Registration
July 8-12

Please complete this form to register for "Camp @ Church". The camp is designed for kids entering grades 1-6 in the Fall of 2024.
If you are registering for more than three kids, you will need to fill out two forms; our apologies for the inconvenience! Camp at Church cost $50 for one child, or $80 total for families with two or more siblings.

Fields with an asterisk (*) are required.

Click "submit" to register. If you have any questions or problems, please email pastorcogan@crossofgrace.org

Child #1: Name

First Name

Last Name

Child #1: Grade (entering Fall 2024)

(optional) Child #2: Name

First Name

Last Name

(optional) Child #2: Grade (entering Fall 2024)

(optional) Child #3: Name

First Name

Last Name

(optional) Child #3: Grade (entering Fall 2024)

Parent Name(s)

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Email Address

Parent Phone

(###)

###

####

Emergency Contact (if different from parent)

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Allergies

List your child's allergies here: food, medication, etc.

Photo Release for Cross of Grace Lutheran Church and Lutheran Outdoor Ministries Indiana Kentucky Synod

I give permission for use of photographs including my child in LOMIK and Cross of Grace publicity. I waive the right to inspect or approve any photos used for such purpose.

I have read and agree to the terms and conditions above.

I do not give permission to take photographs of my child.

Other Information

Use this space to provide any additional information you need us to know, such as medications that may need administered or anything else that will help your child have a great experience.

"Camp @ Church" RegistrationJuly 8-12

"Camp @ Church" Registration
July 8-12