Children's Choir Camp Registration

Children's Choir Camp Registration Form

Camper:

Age:

Address:

Home Phone:

Parents' Name (s):

Parent's Email:

Camper's Email:

Emergency Contact Information:

Name:

Phone:

Relationship to camper:

Does your camper have any medical conditions, allergies, or special needs of which we should be aware?

YES NO

If yes, please explain:

Other important information about your child:

After you submit your form, please mail your payment ($20 per child) to the following address:

St. Mary's-on-the-Highlands

Attn: Richard Byrd

1910 12th Avenue South

Birmingham, AL 35205

DEADLINE TO REGISTER AND PAY IS FRIDAY, JUNE 14, 2013.