Camp Registration

Camp Registration Form

Camp Week

The Group Leader and will serve as the primary point of contact for that group

Group Leader's Name

Group Leader's Phone Number

Group Leader's Email

Church Name

Church Phone Number

Church Address

City

State

Zip Code

Gender	Camper's Name

Registering Pastor or Pastor's wife

Yes

Gender	Name	Phone Number

Would you like to register chaperones as well?

Yes

Gender	Chaperone's Name	Phone Number

Total Campers

Total Chaperones

$25 registration fee (per a camper/chaperone)

Number of campers/chaperones to pay in full now ($100 each)

This is in addition to the $25 registration fee per camper, which is already included above.

List the first and last name of each camper and/or chaperone you are paying in full for (enter “Everyone” if you are paying for the entire group).

Pay-in-Full

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Pay with Card (Stripe)

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