Kids Camp - Cypress Creek Church

Phone

This field is for validation purposes and should be left unchanged.

Number of children registering:*

Please enter a number from 1 to 4.

(must be 4 years old by June 16th, 2026)

Child #1

Name (Child #1)*

First Last

Birthdate (Child #1)*

(must be 4 years old by June 16th, 2026)

Grade (Child #1)*

(entering into the fall)

Food allergies? (Child #1)*

Yes

No

Food allergies (Child #1):*

Do you want to purchase a t-shirt (Child #1)?*

Yes

No

Each t-shirt is $12 and pre-payment is required.

T-Shirt Size (Child #1)*

2026 Kids Camp T-Shirt

Child #2

Name (Child #2)*

First Last

Birthdate (Child #2)*

(must be 4 years old by June 16th, 2026)

Grade (Child #2)*

(entering into the fall)

Food allergies? (Child #2)*

Yes

No

Food allergies (Child #2):*

Do you want to purchase a t-shirt (Child #2)?*

Yes

No

Each t-shirt is $12 and pre-payment is required.

T-Shirt Size (Child #2)*

Child #3

Name (Child #3)*

First Last

Birthdate (Child #3)*

(must be 4 years old by June 16th, 2026)

Grade (Child #3)*

(entering into the fall)

Food Allergies? (Child #3)*

Yes

No

Food Allergies (Child #3):*

Do you want to purchase a t-shirt (Child #3)?*

Yes

No

Each t-shirt is $12 and pre-payment is required.

T-Shirt Size (Child #3)*

Child #4

Name (Child #4)*

First Last

Birthdate (Child #4)*

(must be 4 years old by June 16th, 2026)

Grade (Child #4)*

(entering into the fall)

Food Allergies? (Child #4)*

Yes

No

Food Allergies (Child #4)*

Do you want to purchase a t-shirt (Child #4)?*

Yes

No

Each t-shirt is $12 and pre-payment is required.

T-Shirt Size (Child #4)*

Contact Information

Parent's Name*

First Last

Phone*

Email*

I’m interested in serving during Kids Camp in these areas:

Check-in / Check-out

Group Leader

Breakfast Team

Select all that apply.

To help us provide the best care, please share any relevant medical or behavioral needs?

Payment

Total

Credit Card

Card Details

Cardholder Name

Address

Street Address City State ZIP Code

Parent Release

Emergency Contact Name:*

Emergency Contact Phone Number:*

Insurance Company:

Insurance Policy #:

I, the undersigned, hereby release Cypress Creek Church, it's agents, employees, officers and servants, from any and all damages and injuries which may occur while (I/ my child) is participating in any/all Cypress Creek Church activities, on or off the premises. I also give my permission for Cypress Creek Church leadership to seek medical attention by a licensed physician in the event of a medical emergency. I certify that I have the legal authority to execute this release on behalf of (myself/ my child). I also agree, by signing below, that the above information is true and correct to the best of my knowledge.

Parent/Guardian Signature*

Date*

Cypress Creek Church

Kids Camp 2026

Register

2026 Kids Camp

Child #1

Child #2

Child #3

Child #4

Contact Information

Payment

Parent Release

2025