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Sports Camp Registration Form
June 20-23, 2011
9:00 a.m. - 11:30 a.m.
For all youth entering grades 3-9
Cost is $8/camper - Please make checks payable to FRPC
(includes water bottle, refreshments, and prizes!)

Camper's Name: *
Grade in fall of 2011: *
Street address: *
City: *
State: *
ZIP: *
Parent/Guardian: *
Home telephone: *
Email address:
In case of emergency, contact: *
Relationship to child: *
Phone: *
Child may be picked up by:
Please place my child with:
Home church:
Allergies: Yes   No
If yes, please list:
Medical concerns: Yes   No
If yes, explain:
(Water bottle availability guaranteed only if you register by June 1st)
Enter text from verification image: Type verification image in the box to the left
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Faith Reformed Presbyterian Church
8158 Yellow Springs Rd
Frederick, Maryland
301-662-0662