Creation Camp Registration Grow Camp Camper Name* First Last Age*Birthday*Grade*Gender* Boy Girl Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Parents Names*Which retreat will you attend?*FallSpringFall - Nov. 6-8 or Spring - May 1-3Is your child allergic to anything (medications, foods, etc)?* Yes No If yes, what are your child's allergies?Is your child currently taking any medications?* Yes No If yes, what kind?Do you give permission for medical treatment as may be prescribed by a physician in case of emergency?* Yes No I give permission for Ambassador Camp volunteers to transport my child to camp events and venues.*Yes, I give permission.No, I do not give permission.Promotional advertisements are used by Ambassador Camp. I understand and agree that my child may be used for such advertisements and that Ambassador Camp is released from all liabilities.* Agreed Signature*Your typed name is considered an electronic signature
