Skills Camp Registration Form

Parent/ Guardian First + Last Name

This address will receive a confirmation email

Phone

Address

Emergency Contact Name & Phone Number

Student Registration

Child #1 (Full Name & Allergies)

Child #1 Date of Birth

Child #1 - Skill Selection

Soccer Baking Robotics (limited space; must be 8+ yrs)

Child #2 (Full Name & Allergies)

Child #2 Date of Birth

Child #2 - Skill Selection Soccer Baking Robotics (limited space; must be 8+ yrs)

Child #3 (Full Name & Allergies)

Child #3 Date of Birth

Child #3 - Skill Selection Soccer Baking Robotics (limited space; must be 8+ yrs)

Child #4 (Full Name & Allergies)

Child #4 Date of Birth

Child #4 - Skill Selection Soccer Baking Robotics (limited space; must be 8+ yrs)

Child #5 (Full Name & Allergies)

Child #5 Date of Birth

Child #5 - Skill Selection Soccer Baking Robotics (limited space; must be 8+ yrs)

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 30-August 1, 2026

Fuel your child's curiosity this summer! Our three-day skills camp offers either hands-on experience in robotics (ages 8+ with limited spots!), baking, and soccer for ages 5-11. This exciting environment is designed to build confidence, spark new friendships, and master new hobbies. Don't miss out!

Dates: July 30th-August 1st
Times: 6:00-8:30pm

*Closing Ceremony: Sunday, August 2, 10-11:30 am

Community Baptist Church
43100 Center St., South Riding, VA 20152

Skills Camp Registration Form

Description

Please Fix the Following