Participant Registration

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First Presbyterian Church

Location

10885 ONeal Road

Gulfport, MS 39503

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Contact Austyn Cain:

228-863-2664

acain@fpcgulfport.org

First, Tell Us About Yourself:

Parent Information

THIS REGISTRATION FORM WILL ADD YOUR CHILD TO THE WAITLIST. YOU WILL RECEIVE AN EMAIL IF A SPOT OPENS UP.

First Name

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Last Name

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Address 1

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup 2 Name

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Home Church Affiliation

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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*Nursery and Preschool are reserved for volunteers only.

Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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Grades 3-6 can request 4 activities. They will be placed into 2 of those choices. Activities are assigned by date registered and are first come, first served.

If your child is entering grades 3-6, please type in your child's top four choices from these activities:

~~Watercolor~~, Macrame (string art), Sewing, ~~Mixed Media~~, ~~Music~~, Drama, ~~Acrylic Painting~~, ~~Confectionary Arts (fun with food)~~

First Choice:

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Second Choice:

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Third Choice:

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Fourth Choice:

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I UNDERSTAND THAT THIS FORM ADDS MY CHILD TO THE WAITLIST AND THAT I WILL RECEIVE AN EMAIL IF A SPOT OPENS FOR MY CHILD.

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Photo Release: Do we have permission to use your child's photo on our Camp Design Facebook page? Names will not be included with photos.

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