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First Name
Last Name
Email
Week of camp attending (weeks are based on grade entering for the 23/24 school year)
Junior (3 and 4th graders)
intermediate (5th and 6th graders)
Junior High (7th &8th graders)
Senior High (9th-12th graders)
T-shirt size (only guarnteed for those registered by May 20, 2022)
Youth Medium
Youth Large
Adult small
adult medium
adult large
adult Xlarge
Adult 2XL
Adult 3Xl
Address 1
Address 2
Country
City
State
Zip/Postal Code
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Parent/Guardian information-Emergency Contact #1
First Name
Last Name
Number Input
Email Address
Emergency Contact #2
First Name
Last Name
Number Input
Email Address
Relationship
Please select one
mother
father
grandparent
aunt
uncle
sibling
babysitter
other
Insurance Company
Policy #
Requirements
I understand that I am responsible for the $40 registration fee per child.
I understand that my child will participate in the June 11th church work day
Any Questions or Comments?
Submit