RTLC Day Camp • Joy Lutheran Church

Date & Time

June 24, 2024 9:00 AM - 3:00 PM

7 out of 60 remaining tickets available

Type

Price

Quantity

RTLC Day Camp Registration

7 Remaining

Price
$50.00

Quantity

Enter discount code

RTLC Day Camp Registration 0

2024 RTLC Day Camp Registration

Please complete all required fields.

Camper Information

Camper's First Name *

Camper's Last Name *

Grade Entering in the Fall *

Would you like to pre-order a T-Shirt? *

Camper's Preferred Name *

Date of Birth *

Gender *

T-Shirt Size

Home Address *

Home City *

Home State *

Home Zip Code *

Camper's Health/Medical Information

Do you carry medical insurance? *

Insurance Carrier *

Group/Policy Number *

Physician's Name *

Physician's Phone # *

Are your child's immunizations up to date? *

Conditions/Diseases to be aware of

Dietary Restrictions/Allergies *

Does camper carry an Epi-pen?

Yes

Any Other Health & Wellness Concerns

Parent/Guardian Contact Information

Parent/Guardian #1 *

Preferred Phone # *

Primary Email Address *

Parent/Guardian #2

Preferred Phone #

Secondary Email Address

Emergency Contact Information (if different than above)

Emergency Contact Person

Emergency Contact Relationship

Emergency Contact Phone #

Permissions

I am the lawful adult parent or guardian of above child. *

Yes

My Child has permission to take part in all Day Camp activities led by Rainbow Trail Lutheran Camp (Camp) and hosted by Joy Lutheran Church (Church). I agree that the Camp, Church, and their personnel will not be held responsible for accidents arising therefrom. I give Camp and Church personnel permission to seek medical treatment for my child in case of injury or illness. I also given permission for photos, video, and electronic images to be taken of me or my child and used for by the Camp or Church for promotional purposes without compensation, inspection or approval. *

Yes