Parent/Guardian Name

Relationship to Camper

Parent/Guardian Email

Yes, it's ok to add me to the monthly Footsteps Camps Newsletter.

Parent/Guardian Phone Number

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Parent/Guardian Address

Would you like to enter another parent/guardian's information?

Name of Person Camper Primarily Lives with

Relationship to Camper

Church Attending (if applicable)

Emergency Contact

Emergency Contact Number

Emergency Contact 2

Emergency Contact 2 Number

Name of Person 1 Authorized to Pick up Camper

Cell Phone Number of Person 1 Authorized to Pick up Camper

Provide a Pickup code word

The person picking up your child must have this word, even if they are an authorized pick up person.

Event Registration Software by RegFox

Footsteps, 3/4ths...

July 30-August 1

LifeChange Camp

Clinton, Missouri

PARENT/GUARDIAN INFORMATION