JR Survival Camp - Reg Form

Junior Survival Camp - Sign-up Now!

Please complete the below form to register camper.
Camper Name*

First NameLast Name
Grade In Fall*
Camper's Date of Birth*
Camper Sex*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Parent/Guardian Name*

First NameLast Name
Home Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
Work Number

Area CodePhone Number
Church Name
Special notes or comments

My Products

Junior Survival Camp$169.00

Picture CD/DVD (Recommended)$9.00

Online access to downloadable pictures from your week(s) at The Wilderness Christian Camp. Pictures can be accessed from a smart phone, computer, or tablet.

Buy Camp T-shirt in Advance$24.00

What Size?

Pre-pay for Snack Shop-25$25.00

Pre-pay for Snack Shop-35$35.00

Pre-pay for Snack Shop-45$45.00

Rent Sleeping Pad $15.00

(This is a lightweight foam pad)

Enter coupon

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Junior Survival Camp - Sign-up Now!