Summer Camp Registration Application

Emergency Contacts: Please list two names other than the parents/guardians

Authorized to Pick Up

Health Information

Children who do not attend Quad Cities Christian School must provide immunization records and present birth certificate upon registration.

Swim and Field Trip Permission

My child has permission to go swimming and on field trips as a participant in the program. I understand that the necessary safety precautions will be taken for the supervision of the children.

Summer School Option


Scroll to Top