2026 PVBC Summer Camp Registration Form

2026 Summer Camp Registration Form

Please read and fill out this form in its entirety. Thank you!

1) We require a non-refundable $50 deposit to reserve a camper spot. Balance is due by June 30, unless alternate arrangements have been made. Registration fees (minus the non-refundable $50 deposit) may be returned if cancelled before June 25th.

*No refund will be given for campers leaving early.

2) Our office will provide an acceptance package via email which will include further details such as times, a packing list, a waiver, and a medical form.

3) All horse-program campers will be required to fill out the PVBC horsemanship skill assessment located at the end of this application.

Note:
• If you are intending to apply for the Breakthrough Discipleship program, please click here.

• If you are intending to apply for Family Camp, please click here.
Camper Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
First TimeReturning
MaleFemale
Age on Dec 31, 2026*
Cabin-Mate Request (Max 1 Request Guaranteed)
*Please make sure your requested cabin-mate also requests you on their registration form
Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Parent/Guardian Information
Parent/Guardian Full Name*

PrefixFirst NameLast Name
Home Phone Number

Area CodePhone Number
Mobile Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Email Address*
example@example.com
EmailMailNo Thanks
Please explain if the camper has a medical condition, severe allergy, dietary restriction, disability, or if a person(s) are not permitted to visit or take the child from camp. Any other notes or special requests may be added here as well.
YesNo
Please explain this camper's need for a 1-on-1.*
Photography Notice: Photos and videos may be taken during camp and used for promotional purposes (such as brochures, social media, and our website). If you do not wish for your child’s image to be used, please contact the camp office and we will make note of your request.

2026 Summer Camp Registration Form

Camper Information

Parent/Guardian Information

Camp Session Information

Bike Camp

Select Payment Option: