2010 Music Camp Registration

Performing Arts Camp with Frick and Frack

sponsored by Ramoth Baptist Church

Child's Name:

Child's Birthdate (mm/dd/yyyy)

Grade completed this year

Parent's Name:

Street Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Cell Phone:

What is the best number to contact in case of emergency?

Parent's Email:

Medical or other important information we need to know about your child:
(Please include any food allergies.)

Emergency Contacts:

Name:
Contact Number:

Who is allowed to pick up your child from camp?

Do you attend another church?

If so, where?

If you are visiting, who are you a guest of?

May we have permission to photogragh your child?

May we have permission to use your photograph in church publications for the purpose of promotion?

T-shirt size: