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Register for Camp

Student First Name

Student Last Name

Registration Type

Church Affiliation

Gender

Male

Female

T-Shirt Size

Birthday

Address

Please list any dietary needs that are medically necessary and any food allergies.

Is the camper fully immunized? ( the COVID-19 vaccine is not taken into account for this question.)

Please list any specal needs, allergies, medical conditions or other medical information you feel the camp should know.

Parent / Guardian Information

Phone

Email

I give permission for my students image in both photograph and video to be used for promotional purposes. Student names will not be published with photgraphs or video.

Payment can be made through your local church! We are excited to see your student at camp!

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