Anchorette Baton Camp Registration

 
Baton Camp 2017

June 19 -23 * 9am to 12:30pm

For ages Kindergarten and up for School Year 2017-18

Located at Advent Gymnasium

$110 per twirler

Includes: Fun week of twirling, dancing, t-shirt, snacks,

making new friends and a big show at the end of the week!

ALL LEVELS OF TWIRLING WELCOME!

Bring a Friend!

 

Contact Debbie Dingle for additional information 
 

Registration Form and Payment

 

Student Last Name: (required)

Student First Name: (required)

Student Nickname:

Student Gender: (required) FemaleMale

Student Age: (required)

Student Birth Date: (xx-xx-xx) (required)

Student-Select Grade for 2017-18 School Year (required)

What is the name of the school your child attends? (required)

Parent Street Address: (required)

Parent City: (required)

Parent Zipcode: (required)

Parent Home Phone Number: (xxx-xxx-xxxx)

Student Living with: (required) Both ParentsMotherFatherOther

Mother's Full Name:

Mother's Occupation/Employer:

Mother's Work Phone Number: (xxx)xxx-xxxx

Mother's Cell Phone Number: (xxx)xxx-xxxx

Mother's Email:

Father's Full Name:

Father's Occupation/Employer:

Father's Work Phone Number: (xxx)xxx-xxxx

Father's Cell Phone Number: (xxx)xxx-xxxx

Father's Email:

If student lives with someone other than parent(s)/stepparent(s) as listed above, indicate name, relationship and telephone number:

T-shirt Tank top size: (required)

Authorization for Emergency Medical Care - Person(s) to notify in an emergency if parents cannot be reached:(required)

Emergency Contact Full Name: (required)

Emergency Contact Relationship:(required)

Emergency Contact Home Phone:

Emergency Contact Work Phone:

Emergency Contact Cell Phone: (required)

Name of Students Physician:(required)

Name of Students Physician Office Phone Number:(required)

Student Physical defects, illnesses or allergies (if any)

Student Treatment of Choice (if any)

Student Any additional information you would like to provide?

Will your child be attending Advent's Aftercare after Baton Camp? (required) YesNo

Authorized Pickup 1 Full Name: (required)

Authorized Pickup 1 Relationship:(required)

Authorized Pickup 1 Home Phone:

Authorized Pickup 1 Work Phone:

Authorized Pickup 1 Cell Phone: (required)

Authorized Pickup 2 Full Name:

Authorized Pickup 2 Relationship:

Authorized Pickup 2 Home Phone:

Authorized Pickup 2 Work Phone:

Authorized Pickup 2 Cell Phone:

Are you an Advent Lutheran Church member? (required) YesNo

If no, are you currently active in a local church? (required) YesNo

Name of local church?

I hereby give permission to Anchorettes and Advent Lutheran Church to take photographs or record video tape footage of my child and use them for Advent's social media and advertisement efforts. (required)
YesNo


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After you purchase your ticket – you will receive an email from “ShareFaith Giving”. This will be your ticket to the event.
If you have any questions about the payment, please contact Julie in accounting department here