Click here to print out the registration form.

STOP!!! If you are looking for the Summer Enrichment Program or the FCS Summer School program, THIS IS NOT IT. This is only a week-long day camp. You must check the FCS website to find out about registering your child for summer school.

PLEASE NOTE:  OUR PRICES HAVE CHANGED DUE TO RISING GAS PRICES & RISING FIELDTRIP PRICES.

Jumpin' June Day Camp! Join Harbor Light's Children's Ministries Department for five days of fun and games. We will be going to Malibu Castle in Redwood City on Tuesday; Chuck E. Cheeses in San Jose on Thursday, and jumping in the Jump Houses.

You may print out a registration form at home and drop it off with a picture of your child(ren) and your payment in the Business Office slot which is open 24/7, or you may mail it in at the address listed.  On-line registration is only available for the full five days.  Daily registration must be done with the regular registration form which you may print out above.

Call Children's Ministries if you have any questions: (510) 744-2233

Name of Child:       Grade: 

Name of Child:       Grade: 

Name of Child:       Grade: 

Name of Parent or Guardian: 

 Please check here if you need Before / After care.

Permission Slip and Medical Release Form:

I,  give my permission for   to be part of the "Jumpin' June" program at Harbor Light Assembly of God.  I hereby authorize the leaders of the group to take the above named child(ren) to a doctor or hospital for treatment in case of emergency.

Doctor's Name:       Dr. Phone: 

Health Ins. Co:       Group No.: 

Parent's Work No.:       Parent's Cell: 

Allergies of Child(ren): 

Additional Comments/Concerns: 

First Day Notes:  You'll need to bring in pictures of each child and sign this permission slip when dropping off your child.

NOTE:  DISCOUNTS CANNOT BE TAKEN WHEN USING ON-LINE REGISTRATION. You must print out the form at the top of the page and register for all (4) day camps.