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Registration Form
SonQuest Rainforest
July 19-23, 2010
9 am – 12 noon

Fill in the information below or download an application by clicking here to mail in. Deadline for application is May 15, 2010.

*Required Fields

Child’s Information:

Name: *
Date of Birth (mm/dd/yy): *
Current Grade Level: *
Is this your child’s first time attending camp at The Baptist Church of West Chester? *
What size T-shirt does your child wear? *
Does your child/family regularly attend church? If yes, where? Name of church:
 
Parent’s Information:
Name: *
Street Address: *
City: *
State: *
Zip code: *
Daytime Phone: *
Cell Phone: *
E-mail Address: *
Insurance Company Name: *
Insurance Group #: *
Insurance # required to complete registration.
 
Emergency Contact:

Who should we contact if you are not available in case of emergency?

Emergency Contact Name: *
Emergency Contact Phone: *
Relationship to child (aunt, neighbor, etc.): *
 

Special Concerns:
Does your child have any allergies to food or medication?  If yes, please list:
 

Does your child have any special needs we need to be aware of, such as an IEP, social issues, medical needs, etc.?  If yes, please list:

PARENTAL WAIVER:  By submitting this form I understand that I am releasing the Baptist Church of West Chester and the volunteer teachers and coordinators of any responsibility or any liability incurred by my child during the day camp.  In the case of a medical emergency, I give authorization to the camp coordinators to seek medical attention.

The Baptist Church of West Chester, 221 S. High Street, West Chester, PA  19382
In all we do, we strive to support parents and build spiritually strong children. At the BCWC, you’ll find the Explore! Summer Children’s program, the high-energy excitement of KidMo! and our amazing summer camp Jesus and You! Children are welcomed into worship leadership through their own music, skits, ushering, the reading of scripture, service as acolytes and more. At the BCWC, you’ll also find Family Fun Nights, intergenerational activities, suggestions for family devotions and more. We’re also working to transform our educational spaces. This is an exciting time at the BCWC!


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The Baptist Church of West Chester 221 South High Street West Chester, PA 19382 610.696.7466