West 2019 Kids of Victory

Kids of Victory - Summer 2019

Camper Registration Form - West Location ONLY

This form is for children who have completed Kindergarten (and are 6 by Aug. 1, 2019) through 6th grade

First Name (Name that will be printed on their t-shirt) & Last Name

Age on August 1, 2019

Gender

Male
Female

Grade COMPLETED Spring 2019

Mother's First Name & Last Name

Mother's cell # with area code (If no cell # enter 314-000-0000)

Mother's Email: If no email type [email protected]

Father's First Name & Last Name

Father's Cell # with area code (If no cell # enter 314-000-0000)

Father's Email: If no email type [email protected]

Home Address

Home Phone Number with area code (If no Home # enter 314-000-0000)

Home Church

The School I Attend

Is this your first year at KOV at either location? Yes or No

No - I've attended years

T-Shirt Size (KOV t-shirts cannot be cut or changed during camp.

Registration: Attendance is limited to one session only: Choose only your first choice.

NOW CLOSED - West Session - June 24-28 ($95.00) [Sold Out]

Attendance is limited to this KOV session only. June 24-28, 2019

Yes, I am aware that my child cannot attend additional weeks of KOV at the Crestwood location

Is your child an independent swimmer? (No means Your child requires one-on-one assistance)

In Case of Emergency contact:

Name First & Last

Relationship to Child

Day time Phone # with area code:

Cell # with area code:

Allergies: (Type none if they don't have any)

All medications your child is on: (Type none if not taking any)

Special Needs Considerations: (If none type none)

My child has permission to participate in all Kids of Victory 2019 events and field trips. I give my consent for my child to be photographed as a part of KOV programming and nonprofit promotions.

In the event that my child needs medical attention during Kids of Victory 2019, I give permission for Ministry Staff to administer medical treatment or admit to a hospital for emergency treatment. I further agree to hold harmless and release from liability Southgate Church and/or West Springs Church, its ministers, and anyone acting on behalf of KOV for any and all injuries sustained while at KOV.

Child Approved*

I give permission to administer over the counter medication.

Over the Counter Medications

Name (First Name & Last Name)

* Friend Request Rules

I understand it is my responsibility as the parent to ensure my child's friend request is mutually made by the requested friend's parent. I understand any request other than a one-on-one match between two children registered by April 30, will result in random placement.

Listing multiple names will result in NO friend placement!

Campers cannot be place with teen leaders, except for medical reasons.

By checking the box below, you agree that you have read the above statement concerning a friend request and will abide by it.

Abide by Friend Request Rules*

Early Bird Prices

$75 if registered by April 17

$85 if registered between April 18 and May 17

$95 for all registered after May 17

NO changes can be made after a session closes or May 17 whichever comes first.

NO refunds can be issued after May 17

PLEASE NOTE: If you cancel before May 19 there will be a $5 processing fee for each registration.