Enroll Now

TURNING POINT MINISTRIES CAMP JOSEPH ENROLLMENT FORM

DATE OF ENROLLMENT: 

CAMPER'S FULL NAME: 

PARENT'S NAME: 

GRADE GOING TO:

CAMPER'S BIRTHDAY:                 AGE:

HOME ADDRESS:   

CITY/STATE/ZIP:

PARENT'S HOME PHONE:    CELLPHONE:

WORK NUMBER:

PARENT'S EMAIL:

MEDICAL HISTORY

DOES THE CHILD HAVE ANY ALLERGIES? YES    NO     IF YES, PLEASE LIST: 

DOES THE CHILD TAKE MEDICATION?   YES     NO    IF YES, PLEASE LIST AND HOW OFTEN:

DOES THE CHILD HAVE MEDICAL LIMITATION?  YES    NO  IF YES, PLEASE EXPLAIN:

HAS THE CHILD HAD A PHYSICAL THIS YEAR?  YES   NO

EMERGENCY CONTACT

FULL NAME: 

ADDRESS:

PHONE:     RELATIONSHIP TO CHILD:

FULL NAME: 

ADDRESS:

PHONE:     RELATIONSHIP TO CHILD:

HOW WILL THE CHILD GET TO CAMP AND RETURN HOME?    

  WALK  

 DROP OFF/ PICK UP BY PARENT  

  PICK UP/ DROP OFF BY CHURCH VAN (IF THE CHILD IS PICK UP/ DROP OFF BY CHURCH VAN THERE WILL BE A CHARGE OF $5.00 WEEKLY PER FAMILY)

FOR CHURCH VAN RIDERS - PICKUP/ DROP OFF ADDRESS:

I AGREE THAT ALL INFORMATION ABOVE IS  ACCURATE TO THE BEST OF MY KNOWLEDGE AND AGREE TO MAKE SURE THAT MY CHILD IS AWARE OF CAMP RULES AND WILL ADHERE TO THEM OR THEY MAY BE DISMISSED FROM THE CAMP.

PARENT'S SIGNATURE/ DATE