Camp Location (Pick One) *

Hughes Memorial UMC (25 53rd St NE)

Brighter Day Ministries (2525 12th Pl SE)

My child has attended a Project Transformation camp before:

Yes

No

Child's First Name *

Child's Last Name *

Child's Date of Birth *

Child's Grade (Fall 2021) *

Child's Gender

Female

Male

Non-Binary

Prefer Not to Say

Child's Home Language *

English

Spanish

OtherOther

Child's Race/Ethnicity *

Child's School *

Number of Children in Household *

Number of Adults in Household *

Child's Address *

Child's Address

City

State/Province

Zip/Postal

Country

Does child live with any other child(ren) attending camp? (For Covid Procedures) *

Yes

No

If you answered yes to the previous question, please list the child(ren)

Dietary Restrictions

Food Allergies

Does your child have any medical condition(s) that we should know about to best engage with them? Please include any medications that you would like us to know about. The staff will not administer medication, but a parent/guardian is welcome to come and give their child medicine.:

How will your child get home from camp each day: *

Walk Home

Pick-up

Both

Please List the Names of People Allowed to Pick-up Child

Child's First Day of Camp *

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