FMS Payment Form – Emmaus Summer Camp 2026
Submit payment and camper details for Emmaus Summer Camp 2026 registration.
FMS Information
Name of FMS Organization
*
Name of person submitting payment
*
First Name
Last Name
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Camper Information
Camper Full Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Parent / Guardian Name
*
First Name
Last Name
Parent / Guardian Email
*
example@example.com
Section 3 – Payment Details
Emmaus Summer Camp 2026 Fee
*
Payment Authorization
By submitting this form, you confirm that your organization is authorized to make payment for the above camper to attend Emmaus Summer Camp 2026.
Payment
Emmaus Summer Camp 2026 – FMS Payment
*
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Emmaus Summer Camp 2026 – FMS Payment
Registration fee for Emmaus Summer Camp 2026. Non-refundable.
$
750.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit Payment
Should be Empty: