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