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Franklin Alliance Church

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CAMP COURAGEOUS REGISTRATION

First name

Last name

Address

School Age

Grade K

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Allergies

NUTS

DAIRY

EGGS

OTHER: Please speak with staff

Parent/Guardian Name*

Parent/Guardian Phone

Preference

TEXT

CALL

Parent Email*

Parent/Guardian Consent

I consent to allow my child named on this form to attend Alliance Kidz Zone: Camp Courageous at FAC and hereby release Franklin Alliance Church of liability for injuries or emergencies incurred while attending this event.

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