2023 Mauldin Youth Camp Application

Mauldin Youth Camp Application
This registration is for the Mauldin Youth Camp. It is at the campground located in Simpsonville, SC. Is this the camp you want to attend?*

YesNo
Pee Dee Youth Camp Application

If you would like to register for the Pee Dee Youth Camp don't click next. Copy this link https://form.jotform.com/223344293197157 and paste it in your search bar to go to the Pee Dee Youth Camp located in Marion, SC.

Medical Information
Insurance Company
Policy Number
Group Number
Does the camper have allergies including asthma?
Please explain on the field provided
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake

Contact Information in Case of Emergency
Name*

First NameLast Name
Contact Number*

Area CodePhone Number
Relation to camper*
Name

First NameLast Name
Contact Number

Area CodePhone Number
Relation to camper

How Would you Like to Make a Payment?*

Credit CardCheck/Money Order
Payment

Balance Due at Camp
Signature of parent or guardian representative*

Clear
Signature of parent or guardian representative*

Clear
Should be Empty: