KTDC Camp Destiny 2025
For ages 5 - 18 years old
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
Male
Female
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Mobile Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Camp Session
*
Week 2 Camp: June 09-13
Week 3 Camp: June 16- 20
Week 4 Camp: June 23- 27
Week 5 Camp: June 30 - July 3
Closed - 7/4/25
Week 6 Camp: July 07- 11
Week 7 Camp: July 14-18
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Medical Information
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
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Contact Information in Case of Emergency
Name
*
First Name
Last Name
Contact Number
*
-
Area Code
Phone Number
Relation to camper
*
Name
*
First Name
Last Name
Contact Number
*
-
Area Code
Phone Number
Relation to camper
*
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Payment
Total amount for chosen camps
Signature of applicant or guardian representative
*
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Submit
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