Jesus, It's About Him
2017 Youth Camp Registration
Grade Child Will Be In Aug. 2017
Cell Phone Number
Click image to pay online!
Student's Food Allergies
Emergency Contact Name
Emergency Contact Phone #
Emergency Contact Relationship to Child
Other Allergies or Medical Conditions
May we have permission to photograph and/or video your student for use in church publications?
Yes, you have permission to photograph/video my student.
No, I do not give permission to photograph/video my student.
© Living Water Church. All rights reserved. 200 Fogg Pike Mt. Sterling, KY
"May the grace of the Lord Jesus Christ, and the love of God, and the fellowship of the Holy Spirit be with you all."
2 Corinthians 13:14