Family Camp Registration Form

Oswego Alliance Youth Winter Retreat Registration Form

Starting off the year correct! Jan 1st - 2nd 2021
Camper Name:*

First NameLast Name
Student Grade

7th8th9th10th11th12th
Available Options:*

Friday only ($10, 5pm - 9pm)Saturday only ($15, 9am - 8pm)Both days ($25, sleeping at Grace and Glory)Both days ($25, not sleeping at Grace and Glory, But will be pick up Friday night at 9pm and brought back at 9am on Saturday)
Gender*

BoyGirl
Are you apart of one of our CLGs right now?*

YesNo
Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Relationship:

SiblingParentChildFriendOther
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have any have allergies?

YesNo
Any questions or concern:
Should be Empty:

Oswego Alliance Youth Winter Retreat Registration Form