2026 Kids Camp Registration

We're so excited you want your child to join our week of Kids Camp!
4C's Kids Camp is June 22-26 from 9am-Noon!
$50/Kid. For scholarship questions email us!
Please fill out this form for each child attending Kids Camp at 4Cs, and reach out to us if you run into any issues, or have any questions!

Child's Name

Child's Age (all kids camp attendees must be potty trained)

Date of Birth

Parent Full Names

This address will receive a confirmation email

Parent Phone #

Address

Home Church

Does your child have a friend they'd love to be in a group with? (we can move a child down a grade to be with a friend, but we cannot move a child up in grade)

Is your child going to miss any dates? What days?

Any Allergies, Medical Conditions, or Special Needs?

Emergency Contact # (other than listed above)

Emergency Contact Relationship to Child

Insurance Company or Group and Policy Number

Video/Photography Release: I hereby grant 4Cs and its representatives’ permission to take photo and/or video of me/my child in which the participant appears, in any manner whatsoever such as, but not, limited to: publication, display, advertising, slide shows, etc, without compensation, until rescinded by me. **Initial box below**

I realize Christ Community Covenant Church insurance begins where the individual's health and accident policy terminates. It is only valid when all other insurance has been extended to its limits. The undersigned or a legal parent/guardian of the undersigned realizes that the participant(s) may incur personal injury or bodily damage while participating in such activities, and acknowledges that Christ Community Covenant Church, its officers and its directors, and its employees, its agents, and any parties volunteering on behalf of Christ Community Covenant Church shall be held harmless from all actions, claims, costs, expenses or damages of any kind, growing out of or related to any activity of Christ Community Covenant Church. The undersigned or a legal parent/guardian of the undersigned further acknowledges this is a full and complete release for all injuries and damages which the participant(s) may sustain as a result of participation in any church activity. I, being the legal guardian of the minors registered on this form for activities at 4Cs, give my permission for the minors registered on this form for activities at 4Cs to participate in activities sponsored by Christ Community Covenant Church. The parties agree that this Agreement may be executed with electronic signatures. **By typing your name below, each party confirms that they are intending to be legally bound by this Agreement**

T-Shirt Size (t-shirt included if registered before June 1st. Cannot guarantee a shirt if registered later)

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large

Payment

Any comments?

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2026 Kids Camp Registration

Description

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