NOTICE: Kids Camp is now FULL.

Download a copy of this Application

Download Kids/Teen Camp Permission Slip

Vineyard Camps Registration
Full name of Child
Sex
Date of Birth
Choose Your Camp
Kid's Kamp (ages 9-12; July 10th - 16th) - FULL
Teen Camp (grades 7-9; July 17th-23rd)
Baxter (grades 9-12; July 24th - 28th)
Additional Information
School Name
Grade
T-Shirt Size Adult SM
Adult M
Adult L
Adult XL
Adult XXL
Child SM
Child M
Child L
Child XL
Child XX
Address
E-mail
Parents or Guardians
Relationship to Child
Daytime Phone
Evening Phone
Emergency Contact (other than Parents of Guardians)
Name
Relation
Daytime Phone
Evening Phone
Medical Info
Date of Last Physical
Medications
A COPY OF YOUR CHILD'S SHOT RECORDS IS REQUIRED BY LAW
Insurance Company
Group #
Cert #