WCKCM 2024 Leaders Registration Name * First Name Last Name Age * Phone * (###) ### #### Email * Home Church * Department * Caterpillars VBS Juniors Jr. High High School College & Young Adults Any allergies, medications, or medical conditions? * If none, write "none" Will your parents be at camp meeting? * Yes No Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### If you’re over 18, have you completed the voluntary safety requirements for your home church? Please submit your certificate or a letter from your pastor certifying you. If YES, send a photo or a copy of the letter from your pastor to rocfellowshipsda@gmail.com Yes No Thank you!
