2020 Summer Camp Registration

June 8 - August 7

Emergency Contacts: Please list two names other than the parents/guardians

Authorized to Pick Up

Health Information

Children who do not attend Quad Cities Christian School must provide immunization records and present birth certificate upon registration.
Quad Cities Christian School Summer Camp has my permission to contact either physician when I cannot be reached.

Swim and Field Trip Permission

My child has permission to go swimming and on field trips as a participant in the program. I understand that the necessary safety precautions will be taken for the supervision of the children.
I certify that my child has had the required immunizations, health information above is correct and the information listed is true. I have read and understand the compliance information and will abide by the program regulations.