Elizabeth Baptist Church
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Look Up Lodge Summer Camp
Registration Form
Please complete one form per child who will attend Summer Camp this year.
Child's First Name
Child's Last Name
Parent or Guardian First Name
Parent or Guardian Last Name
Phone Number
Email
Child's Date of Birth
Last Completed School Grade
Allergies, Medications, Other important information
Please list Emergency Contact Names & Numbers
May we photograph your child for promotional purposes?
Yes
No
Submit