summer kickoff

* Students & adults that are attending should fill this form *

* For 6th-12th grade students *

2018 Summer Kickoff

Participant's Name *

Participant's Name

First Name

Last Name

Student's Phone Number *

Student's Phone Number

(###)

###

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Grade / Adult *

Gender *

Parent / Guardian Email Address *

Emergency Contact Name(s) & Phone Number(s) *

Allergies & Medications *

TRIP DETAILS:

DATE: Saturday, May 26 through Monday, May 28

WHERE WE ARE GOING: Camden, AL to Scott & Hilary Hardy's Lake House

COST: $15 per student

WHAT ARE WE DOING: Having fun, swimming, tubing, worshipping with the church in Camden