2021 CNLA Registration Form

2021-2022 Camp NOW Leadership Academy

Virtual Leadership Academy Registration Form
Participant Name*

First NameLast Name
Birth Date*

MonthDayYear
Name of School*
Self-Identified Pronoun
He/Him Her/She They/Them
Shirt Size*
Parent/Guardian*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian E-mail*
Parent/Guardian Mobile Number*

Area CodePhone Number
Parent/Guardian Work Number

Area CodePhone Number
Payment Plans:

$200 One-Time Payment Now

OR:

$50 Non-Refundable Payment Due Now

Refund Policy:

Refunds must be asked before by May 25th. No refunds after such date.

For Group Rates (5+Students) Contact Cameron Friend

Cfriend@thekingcenter.org
Camp Now Leadership Academy Payment

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USDCamp Now Leadership Academy Registration Payment

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

2021-2022 Camp NOW Leadership Academy