California Christadelphian Kids Camp 2026

Attendee Registration

Primary Guardian Information

Full Name

Phone

Address

Address Line 1

Address Line 2 (Optional)

City

State

ZIP Code

Second Guardian Information (Optional)

Full Name

Phone

Same address as primary guardian

Emergency Contacts

Please provide at least one emergency contact (someone other than the guardians listed above).

Emergency Contact 1 (Required)

Full Name

Phone Number

Emergency Contact 2 (Optional)

Full Name

Phone Number

Attending Children/Youth

Child

First Name

Last Name

Date of Birth Attendees must be between 9 and 17 years old on June 21, 2026 (camp start date)

Gender

T-Shirt Size

This attendee plays piano

Phone Number

Ecclesia

Same address as primary guardian

Medical conditions

Dietary restrictions

Allergies

Special Needs or Additional Notes

Medical Consent

I authorize camp staff to seek and approve emergency medical treatment for any attendee in this registration if required. I understand that every effort will be made to contact the guardians and emergency contacts listed above, but in the event of an emergency where guardians cannot be reached, I give permission for necessary medical care.

I agree to the terms and conditions and understand that all information provided is accurate to the best of my knowledge.