Registration Form

JBC 1 has 22 spots available   JBC 2 has 4 spots available   JBC 3 has 0 spots available   (2021/5/3)       

***JBC 3 is FULL - please register to be put on the waiting list***

General Information

Parent/Guardian Information

Full time Christian worker *
Parent is a full time pastor or missionary

Emergency Contact Information

Health & Insurance Information

Is your child enrolled in Japanese National Health Insurance *
Any Special Medical Conditions or Concerns *
Medication Taken Daily *
Any allergies *
Restricted Activity (Is this camper to be restricted from an activity?) *
Has had the tetanus immunization vaccine *
Do you have any serious concerns about the above questions? *

Travel Information

 

Arrival *
Departure *

Release of Liability

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