FBC Camp Registration

1. Camper Name:

2. Camper Age:

3. Parent 1 First and Last Name:

4. Parent 2 First and Last Name:

5. Emergency Contact First and Last Name:

6. Parent 1 Phone Number;

7. Parent 2 Phone Number:

8. Emergency Contact Phone Number:

9. Parent 1 email address:

10. Parent 2 e-mail address:

11. Camper Address:

12. Are you aware of any campers that you prefer to have your child grouped with? (Groups will be no larger than 6)
Please provide their names here:

14. Upload additional Forms for Camper Registration