2024 Family Camp
(All Ages)
July 19-21
Disciples Center at Tawakoni
Camper's Full Name:
*
Sex:
*
Female
Male
Grade Completed:
*
(Choose One)
Pre-K (ages 3-5)
Kindergarden
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Adult
Parent/Guardian Name (if minor):
Parent/Guardian Email
*
Phone Number
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Federated States of Micronesia
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French Part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Address
*
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State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
AA
AE
AP
Home Church
*
(Choose One)
Arkansas City Central CC
Atchison FCC
Atwood FCC
Augusta FCC
Baxter Springs FCC
Caldwell Central CC
Chanute FCC
Cheney Trinity United CC
Clearwater FCC
Coffeyville FCC
Colby FCC
Columbus FCC
Conway Springs FCC
Dighton FCC
Douglass FCC
Emporia FCC
Erie FCC
Eureka Christian & Congregational Church
Everest Christian Church
Fredonia FCC
Galva Christian Church
Garden City FCC
Garden City, Iglesia Discipulos de Cristo
Girard FCC
Garden Plain Community Church
Goodland FCC
Gorham Community Church
Great Bend FCC
Haysville FCC
Herington FCC
Hiawatha FCC
Holton FCC
Horton FCC
Hutchinson Park Place Christian Church
Independence FCC
Kensington, United Church of
Kingman Christian Church
Lawrence FCC
Leavenworth FCC
Lebanon FCC
Lewis Christian Church
Liberal FCC
Lyons FCC
McPherson FCC
Madison FCC
Manhattan FCC
Marysville FCC
Neodesha FCC
Newton FCC
Oberlin, United Church
Ottawa FCC
Oxford Christian Church
Parsons FCC
Pittsburg FCC
Potwin FCC
Pratt FCC
Rock Christian Church
Salina Belmont Boulevard Christian Church
Salina FCC
Sawyer Christian Church
Scott City FCC
Sedan FCC
Smith Center FCC
Stafford FCC
Topeka FCC
Topeka West Side CC
Utica FCC
Wellington FCC
Wichita, New Hope Christian Church
Wichita, Hillside Christian Church
Wichita, North Heights Christian Church
Wichita, Oakview Christian Church
Wichita, Pine Valley Christian Church
Wichita, Riverside Christian Church
Wichita, Woodridge Christian Church
Other/ Outside Kansas DOC Church
Other/Non-DOC Church Member
T-Shirt Size
*
(Choose One)
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult XXXL
Camp Photos
Do you consent to pictures of your child at this event being used for publication?
*
Yes
No
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