OnTrack- Reg Form

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

Please briefly explain why camper is attending this program. (Later you will have an opportunity to give us a detailed explanation on a "Camper Behavioral Form")

Special notes or comments

My Products

OnTrack$465.00

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

T-Shirt

Pre-pay for Snack Shop - 45$45.00

Pre-Pay For Snack Shop - 60$60.00

(This $60 option is the average amount a camper typically uses during this program)

Pre-pay for Snack Shop - 75$75.00

Rent Sleeping Pad $15.00

(This is a lightweight foam pad)

Airport Shuttle$30.00

(Our staff will safely transport camper to or from Yeager Airport in Charleston, WV)

1 or 2 (One Way or Round Trip)?

Bus Station Shuttle$30.00

(Our staff will safely transport camper to or from Greyhound Bus Terminal in Charleston, WV or Ripley, WV)

1 or 2 (One Way or Round Trip)?

Enter coupon

Total $0.00

Payment Methods

Debit or Credit Card

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

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