Kids Camp

July 7-12, 2019 - Ages 7-11

Registration Details:
Before May 15 - $210.00
Before June 15 - $230.00
After June 15 - $250.00

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* Indicates required field

Campers Name *

First

Last

Gender *

Age *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent or Guardians Name *

First

Last

Emergency Contact Phone Number *

Care Card Number *

*Note - registration is not complete until deposit has been made

Phone Number *

Home Church (if applicable) *

Email *

I give permission for my childs photos to be used for camp promotional material in the future. *

Yes No

Allergies or Medications *

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