Youth Camp 2026

AZ June 5-7

Winterfest Promo - $200.00 until March 7th

Early Bird - $220 until May 7th

Regular Price - $250 until May 19th

Registration closes May 19th 2026

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CA June 11-14

Winterfest Promo - $200 until March 7th

Early Bird - $220 until May 19th

Regular Price - $250.00 until May 26th

Registration closes on May 26th

NO EXTENSIONS

All applications must be mailed and received within 1 week of the date of registration.

For counselor applications please contact the regional office at 909-931-0700. Must be 21 + years of age.

Campers Name*

First NameLast Name

Campers E-mail*

Campers Birth Date*

MonthDayYear

Campers Date of Birth*

Campers age:*

FemaleMale

Campers Parent/Lagal Guardian:*

First NameLast Name

Phone Number*

Area CodePhone Number

If any of these questions do not pertain to you please answer with an N/A or NONE

Medication Name*

Make sure Camper takes medication on original container that has Medication and doctor info

Allergies to any medication or food:*

Health Insurance Name:*

Health Insurance policy:*

Contact in case of an emergency:*

First NameLast Name

Relationship to Camper*

Phone Number of emergency contact:*

Area CodePhone Number

Church Name*

Pastor*

State:*

Arizona / California

Payment*

Deposit $78.00

The remaining balance is due 2 weeks before camp. Money order or church check Only. NO PERSONAL CHECKS OR CASH

Campers full payment$228.00

AZ REGISTRATION

Campers full payment $228.00

CA REGISTRATION

Choose Tribe Color$ Free

THERE ARE 6 COLORS TO CHOOSE FROM, (POTENTIAL COUNSELORS MUST CHOOSE A COLOR)

California Tribe ColorArizona Tribe Colors

Enter coupon

YOU WILL RECEIVE AN APPLICATION BY EMAIL OR YOU CAN PRINT THE ONE BELOW

FOR YOUR REGISTRATION TO BE COMPLETED AND HAVE YOUR SPACE RESERVED THE APPLICATION MUST BE FILLED OUT COMPLETELY AND SENT TO THE REGIONAL OFFICE AS SOON AS POSSIBLE WITHIN 1 WEEK FROM THE DATE OF YOUR REGISTRATION.

Church of God SWR

149 N 3rd Ave. Upland, CA. 91786

MUST HAVE:

PARENT/LEGAL GUARDIAN SIGNATURE IF UNDER AGE OF 18
CAMPER SIGNATURE
Sr. PASTOR SIGNATURE (Not youth pastor or leader's signature)

DEPOSIT OR FULL PAYMENT IS NOT REFUNDABLE OR TRANSFERABLE

Campers Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code