Rainbow Trail Bible Day Camp 2025
Please fill out this form and click submit.
*This form needs to be completely filled out by a parent/guardian. It will be kept by the Church
staff
* The cost is $10 per camper. This covers a T- shirt, snacks, and craft supplies.
Pay here $10 fee
Camper Information
First name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Birthdate
*
Parent/Guardian
*
Phone
*
Parent/Guardian
Phone
Emergency Contact
*
Relationship with camper
*
Medical info/Insurance
Do you carry medical/hospital insurance?
*
Please select one option.
Yes
No
If so, please indicate:
Carrier
Group/Policy Number
Name of physician
Phone
Date of last immunizations for:
TPD
*
Tetanus
*
Measles (MMR)
*
Polio
*
Please check and date any of the following, which have occurred to the camper or in the camper's family:
Conditions, Diseases, Allergies
*
Please select all that apply.
Frequent ear infections
Heart diseas/defect
Convulsions/siezures
Diabetes
Bleeding/clotting disorders
Hypertension
Mononucleosis
Chickenpox
Measles
Mumps
Asthma
Hay Fever
German Measles
Ivy poisoning
Insect stings
Penicillin
Other drugs
Psychiatric counseling
Other
Please explain any of the above
Operations/serious injuries. Please explain.
Suggestions, activity restrictions, or other health related information for camp personnel
Will your child need to take any medications during day camp?
*
Please select one option.
Yes
No
If so, please list medications
Select your preferred T-shirt size (Everyone will get a t-shirt. We will do our best to ensure you get your preferred size, but cannot guarantee if you register after May 1st).
*
Please select one option.
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
My child has permission to participate in all camp activities, except as noted. I hereby give permission to the medical personnel selected by the camp director to order X-rays, routine tests and treatment for the health of my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to hospitalize or secure proper treatment (including surgery, injection, and/or anesthesia) for my child as named above. I hereby autorize the capture of photos and/or video of my child during the camp, for the purpose of their potencial use on our website and social media plataforms.
*
Please select one option.
Parent/Guardian concent
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following