Hilliard Inflatables, LLC
ST. JAMES LUTHERAN CHURCH
SPORTS AND GAME CAMPS
REGISTRATION FORM
Child’s Information
Name __________________________________________
Address_________________________________________
_________________________________________
Gender M F
Birth date _______________________
Parent/Guardian Information
Name____________________________________________
Address (if different)_________________________________
_________________________________
Relationship to child_________________________________
e-mail address_____________________________________
Phone numbers:
Home________________________
Work_________________________
Cell__________________________
Emergency Contact Info (if parent/guardian cannot be reached)
Name___________________________________________
Phone number______________________
E-mail address____________________________________
CAMPS ATTENDING
June 1-5, 2015, Games Galore $275.00 _____________
June 8-12, 2015, Monster Sports $275.00 _____________
June 15-19, 2015, Games Past and Present $275.00 _____________
June 22-26, 2015, Sport Builds Character $275.00 _____________
Total _____________
Make checks payable to Hilliard Inflatables, LLC
Mail to: St. James Lutheran Church
5660 Trabue Road
Columbus, OH 43228
Attn: Hilliard Inflatables