Solsberry Christian Church
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JR/SR HIGH CAMP SIGN UP
Please fill out this form even if you have already filled out a form through CIY!
Participant Info
*
Indicates required field
Participant First Name
*
Participant Last Name
*
Participant Phone Number
*
Email for Followup Information
*
Camper Gender
*
Male
Female
Participant Date of Birth (mm/dd/yyyy)
*
Participant Grade for 2020/2021 School Year
*
5th
6th
7th
8th
9th
10th
11th
12th
Graduated Senior
College
Adult Volunteer
Participant Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent/Guardian Info
Parent/Guardian First & Last Name
*
Phone Number
*
Medical Information
Health Insurance Company
*
Please list ALL medications your students takes regularly:
*
Policy Number
*
Please list ALL allergies food and otherwise of your student:
*
Emergency Contact Information
Emergency Contact Name
*
Phone Number
*
Emergency Contact Name
*
Phone Number
*
Submit
Home
I'm New Here
Who We Are
How To Connect
About SCC
Elders & Staff
SERMONS
Events
Calendar
Building Use Form
Ministries
Adults
Sr High
Jr High
Pre School
Elementary
PRAYER WALL
Contact