Kids Camp 2021
Kids Camp Boomerang is June 27th thru July 1st, 2021
LOCATION: 16330 Baptist Camp Rd Paron, AR 72122
CHECK-IN TIMES: 5:30–6:30 pm Sunday, June 27th
PICK UPTIMES: 11 am Thursday, July 1st
- Please fill out the following
Address 2 (Apt/Suite # etc.)
* Social Security Number
* Place of Birth
* Shirt Size
Allergies / child notes
* Primary Care Physician
* Primary Care Physician Phone
* Insurance Company
* Insurance Company Policy Number
* Insurance Company Group Number
- Please use someone not living in the same household
* Emergency Contact Name
* Emergency Contact Phone #
Parents/Individual Responsible Information
- Please provide information for the person who will be dropping off and picking on a regular basis.
* Parents/Guardian Name
* Parents/Guardian Phone #
* Parent/Guardian Email
* Will someone other than parent or guardian be picking up student?
Head Lice Information Form
- Please read the head lice information form before signing below.
- You must read the release statement and enter your name below in the digital signature field to confirm.
* Digital Signature- I HAVE read the release statement linked above.
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