Kids Camp Zephyr Signup Form

  • Student Info

  • First name of student
  • Last name of student
  • Please enter a value between 3 and 5.
    Grade of student
  • Age of student
  • Student t-shirt size
  • Parent/Guardian Info

  • First name of parent/guardian
  • Last name of parent/guardian
  • Parent/guardian email
  • Parent/guardian phone number
  • Full payment of $295 is due by Wed. May 1, 2019, which includes a non-refundable deposit of $55. Payments can be made thru SecureGive on our app or website, kiosk or offering envelope.

    Here is a link for your convenience.

  • NameMedicationTime 1Time 2Time 3Time 4 
    Add a new row
  • Add a new row
    If no allergies, please type in none.
  • This field is for validation purposes and should be left unchanged.