Summer Worship Arts Registration

Complete the ENTIRE online registration below and mail a check payable to "Mt Pleasant Kids for Christ" with Memo: Summer Worship Arts Camp

c/o Mt Pleasant UMC

6516 Old Greensboro Rd,

Thomasville, NC 27360.

Registration Deadline - JULY 5

Child's Name:

Child's Age:

Grade just completed:

Parent's Name:

Street Address:

City: State: Zip:

Daytime phone:

Email Address:

Will your child attend the Kids Konnection trip on Thursday? (please include an additional $4 if so)

LEARNING MORE:

Are you and your child involved in a church: If so, which one?

Want to hear more about Mt Pleasant?

How did you hear about our Summer Worship Arts Camp?

T-shirt size options: YS YM YL S M L XL XXL

Please enter your child's t-shirt size:

Medical, Medicines, Allergies, Special Instructions:

Permission and Expectations: My child listed above has permission to participate in Summer Worship Arts Camp with Mt. Pleasant UMC. I release Mt. Pleasant UMC and its representatives from any liability pertaining to this event. I also authorize emergency medical treatment for my child should it become necessary for the welfare of my child.

I give Mt Pleasant the right and permission to publish, without charge, photographs and video taken of my child during this event. The photographs may be used in publications, audio-visual presentations, promotional literature and materials, or on the website.

Insurance company:

Insurance Policy Number:

By entering your parent name, date and submitting this registration, you are agreeing to the "Permission and Expectations" listed above.

Parent Name:

Date: