Gen NEXT Camp Registration

Parent/Emergency Contact Info

Parent/Emergency Contact Name:

Parent/Emergency Contact Phone #:

Parent/Emergency Contact Email:

This address will receive a confirmation email

Parent/Emergency Contact Address:

Secondary Contact Name:

Secondary Contact Phone #

I, the parent or legal guardian of the child(ren) listed below release Rock Solid Church, together with the adult leaders, from any and all claims resulting from injury or damage that may be sustained by my child while participating in the activity listed below.

Child

Child #2

Child #3

Child #4

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

Gen NEXT Camp Registration

Description

Please Fix the Following