Amped 2018 VBS Name of Child: Parent Name: Parent Email: Parent Cell Phone: Grade (In the Fall, must meet age requirements to move into Pre-K in the Fall for Pre-K class): Pre-K K 1st 2nd 3rd 4th 5th Current Age: Gender: Male Female Any allergies (food or non-food): If None, enter none Any known medical conditions:If None, enter, none Doctor Name and Phone Number: First Emergency Contact and Phone Number Second Emergency Contact and Number: How did you hear about camp? Friend Flyer Banner Facebook Can you volunteer? yes no For volunteers only, need nursery? yes no To prove you are a human, please tell us which is larger? Please answer question. Ant Whale Flea Please wait. Your request is processing.