Camp Chaos Participant Form

Join us for Camp Chaos at Ebenezer Baptist Church. July 7-11 from 6:30pm-9pm.

Participant 1 Information

Participant 1 Name

*

Guardian Name

*

Guardian Email

*

This address will receive a confirmation email

Phone

*

Address

*

Participant 1 Last Grade Completed

*

Please select one option.

PreK K 1 2 3 4 5 Other

Participant 1 T-Shirt Size (Youth Sizes)

*

Please select one option.

XS S M L XL Adult S Adult M Adult L

Participant 1 Allergies

Multiple Participant Registration

If registering multiple participants for VBS, complete the following section. If not, please leave blank.

Participant 2 Information

Participant 2 Name

Participant 2 Last Grade Completed

Please select one option.

PreK K 1 2 3 4 5 Other

Participant 2 T-Shirt Size (Youth Sizes)

Please select one option.

XS S M L XL Adult Small Adult Medium Adult Large

Participant 2 Allergies

Participant 3 Information

Participant 3 Name

Participant 3 Last Grade Completed

Please select one option.

PreK K 1 2 3 4 5 Other

Participant 3 T-Shirt Size (Youth Sizes)

Please select one option.

XS S M L XL Adult S Adult M Adult L Other

Participant 3 Allergies

Participant 4 Information

Participant 4 Name

Participant 4 Last Grade Completed

Please select one option.

PreK K 1 2 3 4 5 Other

Participant 4 T-Shirt Size (Youth Sizes)

Please select one option.

XS S M L XL Adult S Adult M Adult L

Participant 4 Allergies

Description

Join us for Camp Chaos at Ebenezer Baptist Church. July 7-11 from 6:30pm-9pm.

Please Fix the Following

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