BIBLE DAY CAMP ONLINE ENROLLMENT FORM

Calvary Baptist Church
Elko, Nevada 89801
738-6840

Please complete the form below.
If you need to start over, click "Clear".
Click on "Send" when ready to submit information
You will given a chance to review your information after clicking "Send"

If You Need Help or Additional Information, please contact the Church Office.


Bible Day Camp 2009

Child's Name

Age

Birthdate

Current Grade

Grade Entering in Fall

CBC Class Attending

Parent/Guardian Names

Street Address

Home Phone

Mailing Address

Zip Code

E-Mail Address

*Allergy/Medical Info/Special Needs

Emergency Contact: Name/Phone No.

Child Comes to CBC Class With: Parent/CBC Van/Other (Explain)

Child Leaves CBC Class With: Parent/CBC Van/Other (Explain)

Where Will Parents be During this Class?

Names of Siblings & Class Attending

PLEASE NOTE: A parent or guardian must sign
and date the Registration Form/Medical Release
on or prior to the 1st day of the activity, to
document permission for their child to attend.