Church Sponsor Registration

Full Name*

First NameLast Name

Sponsor Phone #*

Format: (000) 000-0000.

Sponsor Email

example@example.com

Week of Camp You Will Be Attending

Junior 1 - June 22-26 (Jethniel Wyler)Teen 1 - June 29 - July 3 (Justyn Smith)Junior 2 - July 6-10 (Davide Kim)Teen 2 - July 13-17 (David Sommerdorf)Deaf Week - July 20-24 (Randy Dignan)

Will you have a spouse joining you?

YesNo

Full Name

First NameLast Name

Spouse Email Address

example@example.com

Will any "non-camper" children be joining you?

YesNo

Please list the names and ages of any "non-camper" children who will be with you while you are at Camp Liberty. (These campers will be required to be under your supervision while on camp property, but are welcome to take part in some of the camp activities).

Church Name:

Church Email

example@example.com

Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you understand we may not have accommodations for every leader on site and that you may need to stay in a local hotel?

I understand and am already planning to stay in a hotel.I understand but would be willing to stay in a cabin with the campers if available.I understand but would like to see if on site lodging is still availableI understand and will look for a place to stay nearby

By signing below, I understand that if I accompany campers from our church to Camp Liberty and remain with them during the week, I am required to complete a background check and a child safety course. If I have already completed either of these through my church or workplace, I will upload a copy for review. I also understand that I will receive a brief training session at Camp Liberty on the day of arrival.

If you already have a current background check and/or child safety course certificate, please upload a copy here.

Sponsor Registration Payment*

On-Site Sponsor Registration

The final amount will be based on your lodging and meals and will be calculated when you arrive at camp.

$25.00 Quantity

Off-Site Sponsor Registration

Meals will need to be paid for before you depart on Friday. Cost is $5 per meal

$ Free Quantity

Total

$0.00

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

Please list any dietary restrictions, health concerns, or other information that would be helpful for our staff to know.