Mission Lake Christian Camp
Registration 2025 -- "When the Lion Roars" - Daniel 6
Name
*
Gender:
*
Male
Female
Birthday
*
-
Month
-
Day
Year
Date
Address
*
Mailing Address
Street Address Line 2
City
State
Zip
Parent Phone
*
Format: (000) 000-0000.
Email address
example@example.com
Camper Cell Phone Number
Format: (000) 000-0000.
Facebook Name
May the camp text you?
Yes
No
Are you a member of MLCC Central on Facebook?
Yes
No
Have you been immersed into Christ?
Yes
No
Fall 2025 Grade
*
Please Select
12
11
10
9
8
7
6
5
4
3
2
1
K
High School Gradation Year
*
Please Select
2026
2027
2028
2029
2030
2031
2032
__
Home Church
Church Address
Preachers Name
Preacher Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Invited to Mission Lake in 2025 by my "Buddy" Camper:
who is from church/city
Check which camp you are registering for: (Please use one form per camper per week)
Sr High (9-12 Grade) June 8-13
Jr High (6-8 Grade) June 15-20
Junior (3-5 Grade) June 22-26
Day Camp (1-2 Grade) June 28
Deeper Life/Survival Camp (7-12 Grade) July 6-11
Beloved Retreat (7-12 Grade) July 11-13
Size for Camp T-Shirt:
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Vital health information for camp nurse (Use another paper if needed for more health details
Camper Name: (First, Last)
Copied from name at the beginning
Church
Is camper allergic to any food or drugs
Date of last Tetanus shot
*
/
Month
/
Day
Year
Date
Any major medical problem in the last year or any prescription drugs being used at the present time
Primary Medical Ins Co
*
Policy No
*
Parents signature
Date
*
/
Month
/
Day
Year
Date
Printed Name
*
Cell/Work Phone
*
Format: (000) 000-0000.
Permission is given to use photos of my camper in groups for publicity brochures or on the camp web site.
*
Yes
No
Campers signature
Date
*
/
Month
/
Day
Year
Date
Departure Information
Camper will depart at the end of camp at the time noted on page 1
Camper will depart early on
DATE
/
Month
/
Day
Year
Date
TIME
Camper will be picked up by
Will two or more campers from your household attend MLCC this summer?
Please Select
Yes
No
If registering for Deeper Life Camp: did you attend Sr High camp or Jr High camp?
Please Select
Yes
No
Will a church pay part or all of your camp fee?
Please Select
All
Half
No
Is Camper from a missionary or minister's family?
Please Select
Yes
No
Would you prefer to hand carry your check or credit card to check-in on the day your camp begins?
Yes, hand carry payment to check-in.
No, payment with this online site works.
T-Shirt Code
Early Bird Discount
Deeper Life June Discount
Deeper Life Second Camp
Pre-Registration Payment
Pre-Registration paid before May 31 earns a $20.00 discount for full week camps
Family & Early Bird Discount
Balance Due from Camper (may be paid at check in.)
Do you wish to include the Balance Due amount with today's payment?
*
No
Yes
You may add a donation amount in this box.
Church Pre-Registration
Church Discount
Balance Due from Church
Calculation
My Payment today
prev
next
( X )
USD
This amount may be only the Pre-Registration Fee or it may be the total due depending upon the payment choice made previously.
Preview PDF
Submit
Should be Empty: