Summer Camp Registration – Harmony United Methodist Church

Child Information
Summer Camp is open to rising kindergarten through 5th grade.
Child Name*
First Last
Age*
Gender*
- Male
- Female
Last grade completed*
School Name*
Parent / Guardian Information
Mother / Guardian Name*
First Last
Father / Guardian Name
First Last
Email Address*
Home Phone
Cell Phone
Emergency Information
Emergency Contact*
First Last
Phone*
Allergies or Medical Information
Does child carry an Epi-Pen?*
- No
- Yes
Who has permission to pick up child?*
Use the + icon to add additional names.
Who does NOT have permission to pick up child?
Use the + icon to add additional names.
Special needs or other information to share with camp directors
Camp Information
Camp cost is $100/week per child. Please check the camps you are registering for.
Camps*
- Select All
- Fun & Fitness Camp: July 13-17 (limit 25)
- Art Camp: July 20-24 (limit 25)
- LEGO Camp: July 27-31 (limit 35)
Phone
This field is for validation purposes and should be left unchanged.

Child Information