Camp Grin Again 2019 will be held July 8-12, 2019 at Our Redeemer Lutheran Church

Parents/guardians please register your child below. Registration deadline is July 1st. Please call our office at 940-691-0982 with any questions.

Please fill out a separate registration form for each child you wish to register.

Children's Program Registration Form

Registration for Building Bridges or Camp Grin Again

• Which Program would you like to register for?*
  Building Bridges FallBuilding Bridges SpringCamp Grin Again (Summer Camp)
• Child's/Teen's Name*
  First Last
• Gender*
  • Male
  • Female
• Age*
• Shirt Size (Summer Camp Only)
  NAYouth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeXL2XL
  Select NA if not attending Summer Camp.
• Grade in Fall*
• School*
• Name & Relationship of Person Who Died*
• Nature of Death*
• How Long Ago?*
  1-3 months3-6 months6-9 months9-12 months1-3 years3+ years
• Other Information Related to Death
• Has the child/teen attended Building Bridges or Camp Grin Again*
  NoBuilding BridgesCamp Grin AgainBoth
• Address*
  Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Phone*
• Referring Party
• Medical Needs/Allergies*
• Primary Doctor
• Emergency Contact (Secondary to Parent/Guardian)*
• Emergency Contact Phone Number*
• Emergency Contact Relationship to Child*
• Parent/Guardian Name*
  First Last
• Parent/Guardian Consent*
  YesNo
• Today's Date*