CCD Summer Camp Leader Registration
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shirt Size
*
Please Select
Small
Medium
Large
X Large
XX Large
XXX Large
Leader's Local Church
Please Select
Blue Island Spanish
Bradley First
Chicago Calvary
Chicago Emanuel Spanish
Chicago First Korean
Chicago First Spanish
Chicago Gage Park
Chicago Heights
Chicago Oak Lawn Arabic
Chicago Southside Arabic
Chicago Summit Spanish
Chicago Uptown Vietnamese
College Church University Avenue
Community Cup
Cornerstone Bible
Cristo la Unica Esperanza
Crossroads
Danville Cedar Grove
Danville First
Danville Westside
Ebenezer
El Shaddai
First Naz
Fuente de Vida
GatheringPoint
Grace Community
Greater New Testament
Hoopeston Community
House of Prayer Ministries
Joliet Crystal Lawns
K1
Kankakee Eastridge
Kankakee Salvage Yard Biker
Kempton
Lighthouse Community
Limestone Community
Lombard
Manteno
Milford
Mundelein
Mundelein Spanish
Naperville Trinity
New Future Mongolian
North Chicago
Paxton
Potomac
Resurrection Community
Ridgeland
Sheldon
South Asian Ministries
The Loop
The Table
Total Deliverance
Waukegan Spanish
West Chicago
Wilmington First
Word Fellowship Outreach
Worth
Dietary Needs?
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Payment
The cost for adult leaders is $150. This can be paid by the leader or by the local church. Each church should send in one check for their adult leaders to: CCD Teen Camp, c/o Joel Heald, 200 University Avenue, Bourbonnais, IL 60914.
Submit
Should be Empty: