Kingdom Stars Camp Registration

by | Aug 9, 2024

Registration Fee:
$40 is due at the time of camp registration.

SUMMER CAMP TUITION & PAYMENT:
Summer camp tuition fee is due on every Monday the week that your child is enrolled. If a camper’s tuition is not paid, they will not be able to attend camp.

CAMP DURATION:
— JUNE 2, 2025 – JULY 3, 2025
— Closed June 19, 2024

CAMP TUITION TOTAL:
— Weekly: $135 (7AM – 5PM) Extended Day
— Weekly: $100 (8AM – 4PM) Full Day
— Drop-in day of camp: $35/day
— Siblings- $180/week for two children (full day) $250/week for two children (extended day)

For any additional information, please contact Ms. Brown at 678-983-0818 or email kingdomstarscamp@yahoo.com.

Golden Memorial United Methodist Church, 6903 James D. Simpson Avenue, Douglasville, GA 30134

Kingdom Stars Camp Registration Form

Child(Required)
Gender
Birth DateDate(Required)
Your Address(Required)

Parent/Guardian - Contact Information

Parent/Guardian #1(Required)
Your Address(Required)
Email Address:(Required)
Parent/Guardian #2
Your Address(Required)
Email Address:(Required)

Emergency Contact Information – Alternate Pickup/Release

Emergency Contact #1(Required)
Email(Required)
Emergency Contact #2(Required)
Email(Required)

Medical Release Information

Insurance Information
Address

Please list any medical problems.

Be sure to include any requiring maintenance medication (i.e. Diabetic, Asthma, Seizures).

The purpose for this information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment.
Should paramedic be called?
Should paramedic be called?
Should paramedic be called?
Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?
Is your child allergic to any type of food or medication?(Required)
Does your child require a special diet?(Required)
Guardian Signature:(Required)
Date
Printed Name of Parent/Guardian:


Coordinator Signature

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