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!

My Products

Payment Methods