Campus Mission Academy Registration
Sunday, August 10 - Friday, August 15, 2025 | Miracle Camp and Retreat Center
Name
*
First Name
Last Name
Email
*
example@example.com
UCO Chapter/Location
*
Ann Arbor
Grand Rapids
Lansing
Huntington
Kentucky
Pittsburgh
Maryland
Other
Are you a student or on staff?
*
Student
Staff
Sex
*
Male
Female
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
How many years have you attended CMA?
First Year= 1, Second Year = 2, etc.
What Church Denomination Do You Currently Attend?
*
Please Select
Catholic (Roman)
Non-Denominational
Orthodox (Eastern)
Protestant (Anglican)
Protestant (Baptist)
Protestant (Lutheran)
Protestant (Methodist)
Protestant (Presbyterian)
Protestant (Other)
Other
None of the Above
Phone Number
*
Please enter a valid phone number.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
What size would you like for your CMA T-shirt?
*
Small
Medium
Large
X-Large
XX-Large
If you have any food allergies or dietary restrictions that would be helpful for the staff to know about, please list them below.
If you have any medical conditions that would be helpful for the staff to know about, please list them below.
Any other relevant information we should know?
Your chapter will cover your cost.
How are you going to pay?
*
Pay now in full
I am going to pay my first payment of three installments.
I am going to fundraise my payment.
Your cost is $500 and is due by August 1st, 2025.
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Campus Mission Academy 2025 - Full Payment
$
500.00
Campus Mission Academy 2025 - Installment Payment 1 of 3
$
200.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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