2019 Gospel Tabernacle Kid's Bible Camp Registration

Sunday, June 9th through Wednesday, June 12th - 6:00 pm - 8:20 pm | Please fill out this form and click submit.

Gospel Tabernacle
743 East Main St
Laurens, SC 29360

(864) 984-2217

www.GospelTabernacleChurch.com

Child's Name

*

Date of Birth

*

Sex

*

Please select one option.

Male Female

Last Grade Completed

*

Please select all that apply.

K4 K5 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Parent or Guardian Information

Parent/Guardian Name

*

Address

*

Email address

This address will receive a confirmation email

Home phone number

*

Cell phone number

Will you need van transportation ?

*

Please select one option.

Yes No

Allergies/Medical Information Other:

Emergency Contact (Other than listed above)

Name

*

Cell Phone

*

Address

*

Person Responsible for Picking up Child at end of Kids Camp

Name

*

Phone Number

*

Permissions

May we have permission to photograph your child?

*

Please select one option.

Yes No

May we have permission to use your child's photograph for the purpose of promotion?

*

Please select one option.

Yes No

Description

Sunday, June 9th through Wednesday, June 12th - 6:00 pm - 8:20 pm

Please fill out this form and click submit.

Gospel Tabernacle
743 East Main St
Laurens, SC 29360

(864) 984-2217

www.GospelTabernacleChurch.com

Please Fix the Following

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