Summer Camp | Brookland Church of Christ

2026 CHURCH SUMMER CAMP
At the Ridge Retreat, Paragould, AR

2026 Summer Bible Camp Online Application

Childn's First name

Middle Initial

Last name

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Age

Birthday required

Male

Female

Grade

First Parent/Guardian Full Name

Home or Cell Phone

Work Phone

Employer

Second Parent/Guardian Full Name

Home or Cell Phone

Work Phone

Employer

Emergency Contact

Phone Number

Family Physician

Phone Number

Please list any/all allergies or other medial information

Please list all medications

Note: All medications must be administered by the camp nursing staff. By submitting the form below I give permission for the adove named child to receive emergency medical treatment from a qualified physician while under the care of the camp staff during the week of July 12-17, 2026.

Please make checks out and mail to: The Brookland church of Christ. 9664 Hwy 49-B North, Brookland, AR, 72417

Parent or legal guardian's name

Thank you for your submission!

2026 CHURCH SUMMER CAMP At the Ridge Retreat, Paragould, AR

2026 Summer Bible Camp Online Application

2026 CHURCH SUMMER CAMP
At the Ridge Retreat, Paragould, AR