Camp 116 Kids Camp

July 21-24, 2026

Lakeview Camp - Lone Star, TX
For students who have completed 3rd-5th grade.
$210 per student if registered by May 17
$235 per student after deadline if space is available.
Camper's Full Name
Last Name*
First Name*
Middle Name
Birth Date*

MonthDayYear
Grade*
Emergency Contact's Name*
Relationship to Camper*
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Email*
Camper's T-Shirt Size*
Payment Schedule
May 17 - $70 non-refundable deposit due

June 21 - 2nd payment - $70 due

July 19 - Last payment - $70 due

Scholarships are available upon request.
IMPORTANT NOTE: Registration form is due May 17, 2026. Any registrations received after May 17 will be expected to pay an additional $25 late fee. Also, registrations received after May 17 are not guaranteed a spot and will be put on a waiting list.

PAYMENT METHOD: You will have an opportunity to pay online after submitting this form. If you prefer to pay with cash or by check, you can turn it in at the church office or to Bro. Richard.

SAVE THE DATE: Parent Meeting will be July 19 at 4:00 pm.
Signature
Date

MonthDayYear
Date
Should be Empty:

July 21-24, 2026