Kids Quest Summer Camp

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Kids Quest Summer Camp

 LIMITED OPENINGS!

Please call Becky Jenkins @ 615-672-5339 prior to registering.

 
Kids Quest Registration Form

You must complete the entire form and submit your registration fee for each child you wish to register.

Gender of Child*

Mother's Address*

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Father's Address

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We attend church regularly*

We are a member of the church we attend

Please list a family member and a friend that we can contact in case of an emergency when a parent/guardian can not be reached.

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Family Member Address*

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Friend Address

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Please list all names and ages of children in the family. Type "none" if this does not apply.

Does child have any Health Issues?*

Does your child have any unusual health issues such as allergies, asthma, epilepsy, etc.? If yes, please list in the box below and provide any information we will need to best care for your child.

Has your child had any type of surgery?*

If yes, please list type and date of surgery below.

Enrollment Type*

Enrollment type can not be changed once approved.

Licensing Requirement Agreement*

I understand that this facility/program is not required to be licensed by the state as a child care facility.

Final enrollment will be based on space availability.  A $50 non-refundable deposit is due upon enrollment.  You will be contacted by Becky Jenkins, Temple Children's Director, regarding your application.

Please type your name which serves as a signature stating that you understand all terms set forth above.