Kids Camp Registration 2023

Camper Registration

July 10-13, Grades 3-6
Camper Name*

First NameLast Name
Gender*
Entering Grade*
T-shirt Size (included)*
Roommate Requests
Optional
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Mobile Phone*
Please enter a valid phone number.
Backup Phone
Please enter a valid phone number.
Church*
Other Church*
Instruction for Cabin Leader
This is the only information given to the Cabin Leader. Medical issues will be addressed on the next page.

Payment*

Regular Registration (by June 25) Product Image

Regular Registration (by June 25)Includes 3 nights, 8 meals, camp t-shirt and camp photo

$285.00

Special Dietary Meals (specify below) Product Image

Special Dietary Meals (specify below)Special gluten-free, dairy-free, and vegan/vegetarian options are available. There is a $5 per meal charge for this service. There is no charge for nut-free requests.

$40.00

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Dietary Meal Request

Gluten-free ($5 per meal)Dairy-free ($5 per meal)Vegan ($5 per meal)Vegetarian ($5 per meal)Nut-free (no charge)
Should be Empty:

Camper Registration