Pines Presbyterian Church | Life Camp 2021
Growing with God.
August 2-5 from 9:00AM to 11:30AM
  • NOTES

    Enrollment is limited and acceptance is based on availability at the time of registration. Parents will be notified if camp has reached capacity.

    Your child must be 4 years of age and potty-trained (by July 1st) through entering 5th grade in order to participate in Life Camp 2021. There will be a snack time each day.


    Please fill out a separate form for each child participating.
  • PARTICIPANT INFORMATION

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    (month/day/year)
  • EMERGENCY CONTACT

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  • PAYMENT INFORMATION

    Registration is $5 per child or $10 per family.
    (scholarships are available upon request)


    3 options with how you may pay:

    1. Complete this form and submit the payment form next (to follow).

    or 2. Send Check
    Please make checks payable to: Pines Presbyterian Church
    Write "Life Camp 2021" on the memo line.

    Mailing address:
    Pines Presbyterian Church
    Attention: Life Camp 2021
    12751 Kimberley Lane
    Houston, TX 77024

    or 3. Bring your completed form and payment to the church office front desk and place in the Christian Education mailbox.
  • AUTHORIZATION

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  • has my permission to attend Life Camp 2021 on Aug. 2-5, from 9:00am to 11:30am. I agree for my child’s photograph to be taken and used in future publicity for Pines Presbyterian Church. All personal information about my child will not be disclosed at any time. In the event that I cannot be reached in an emergency, I hereby give permission to the physician or EMT personnel selected to secure and administer treatment, including hospitalization, for the participant named above.
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  • > > > NOTE:
    If you're paying online, you'll be automatically directed to the secure payment form after clicking on the "SUBMIT" button (below):

    On the next form, please specify:

    $5/child
    or $10/family