Candy Cane Camp — Bethlehem Wesleyan Church

Register Below

Name of Parent(s)

First Name

Last Name

Email Address

Phone Number

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Name of Child

First Name

Last Name

Child's Grade

Age of Child

Allergies?

Name of Child

First Name

Last Name

Child's Grade

Age of Child

Allergies?

Any special concerns or needs we need to be aware of??

Checkbox

I hereby grant, to BWC, a license to the use and storage of my child’s image by means of digital or film photography, video photography, and audio recording.

Thank you for completing this registration form. If you would like to register more than two children, please submit an additional form.