2025 Kidz Kamp Registration--Jungle Journey

Parent/Guardian Information

Name

Additional Parent/Guardian Name (if applicable)

This address will receive a confirmation email

Phone

Address

Do you currently attend a church? If yes, where?

If your child was invited by a friend from Grace Bible Church, please share his/her name here.

Emergency Contact

Emergency Contact Phone

Student 1 Information

Student Name

Gender

Male Female

Birthdate

Age Group

5 yrs to Rising Kindergarten Rising 1st/2nd Grade Rising 3rd/4th Rising 5th/6th

Additional Information

Food Allergies Medical Concerns N/A

Please explain your concern/allergy here:

Student 2 Information

Register a second child here. If not applicable, just scroll down and submit the form. If this child has different parent or emergency contact information, please complete a separate form. Thank you!

Student Name #2

Gender Male Female

Birthdate

Age Group

Additional Information Food Allergy Medical Concern N/A

Please explain your concern/allergy here:

Student 3 Information

Register a third child here. If not applicable, just scroll down and submit the form. If this child has different parent or contact information or you have more than 3 children to register, please complete a separate, additional form. Thank you!

Student Name #3

Gender Male Female

Birthdate

Age Group 5 yrs to Rising Kindergarten Rising 1st/2nd Grade Rising 3rd/4th Grade Rising 5th/6th Grade

Additional Information Food Allergies Medical Concern N/A

Please explain your concern/allergy here:

Description

June 11-June 13, 2025 from 6:30 PM to 8:30 PM

Join us for an exciting time! Doors open at 6:00 PM for sign-in every evening. Families are welcomed for ice cream and fireworks following our Friday evening session.

Grace Bible Church
1700 Edwardsburg Ave.
Elkhart, IN

2025 Kidz Kamp Registration--Jungle Journey

Description

Please Fix the Following