Hillside Chapel / Registration Forms / Camp Hillside Form

Register for our event by filling out the information below:

Last Name

First Name

Gender

Age

Date of Birth (mm/dd/yr)

Please enter your full address:

Street Address

City

State

Zip Code

Cell or Daytime Phone Number (xxx-xxx-xxxx)

Parent/Guardia Name (First & Last Name)

Emergency Contact Name (First & Last Name)

Emergency Contact Number (xxx-xxx-xxxx)

Emergency Contact Relationship

Medical Issues Including Allergies if Pertinent

How did you hear about Camp Hillside?

Email Address

T-Shirt Size Alternative Sizing in Parentheses ()

YXS (size 2-4)

YS (size 6-8)

YM (size 10-12)

YL (size 14-16)

AS (34-36 Chest Size)

AM (38-40 Chest Size)

AL (42-44 Chest Size)

AXL (46-48 Chest Size)

AXXL (50-52 Chest Size)

T-shirts aren't guaranteed for registrations submitted after June 4.

As parent or guardian, I give permission for my child to participate in all activities, for treatment if needed by a licensed physician due to accident or injury, and for the use of photos by Hillsice Chapel for promotional use...

Please note that filling out this form is only part of the registration process. Cash or check made out to Hillside Chapel is due to the first day of camp. Cost is $10/person but will not exceed $40/family.

Parent/guardian will be asked to fill out a full liability waiver on the first day of Camp Hillside, June 24.

Please fill out a registration form for each individual participating in Camp Hillside.

Event Registration