Summer Camp Change/Withdrawal Form
ELCA Summer Camp
Camper Name
*
First Name
Last Name
Grade Camper will enter in August 2026
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Current Registration
*
Week 1: June 1-5
Week 2: June 8-12 Camp 323 *Only if you registered through YCEP
Week 3: June 15-19
Week 4: June 22-26
Week 5: July 6-10
Week 6: July 13-17
Requested Changes
Please check ALL that apply.
Withdraw from the following week(s):
Week 1: June 1-5
Week 2: June 8-12 Camp 323 *Only if you registered through YCEP
Week 3: June 15-19
Week 4: June 22-26
Week 5: July 6-10
Week 6: July 13-17
Are you requesting a refund for these weeks? (Subject o policy below)
Yes
No
Change weeks of attendance
Please be sure to list weeks to move FROM and TO
Add the following week(s)
Week 1: June 1-5
Week 2: June 8-12 Camp 323 *Only if you registered through YCEP
Week 3: June 15-19
Week 4: June 22-26
Week 5: July 6-10
Week 6: July 13-17
Other (Please explain)
Submit
Should be Empty: