2025 Peace Camp Registration Form

40th Annual Peace Camp Registration

Friday, June 20-Sunday, June 22, 2025 @ Camp Peaceful Pines
CAMP INFORMATION AND PRICING

***CAMP WAITLIST IS NOW IMPLEMENTED***

The waitlist is implemented when we have reached the desired capacity for camp to ensure that families do not need to bunk with other families.

The waitlist is available for those who are interested in attending if room opens up, so please complete the below form to be put on the waitlist.

Waitlisted campers will be contacted if space is made available and will be required to pay within 2 days to be considered registered.

FULL WEEKEND: 2 nights (Fri & Sat), 5 meals, workshops & activities
- Adult (18+): $130
- Youth (4 -17): $100
- Child (0-3): FREE
HALF WEEKEND: 1 night (Fri or Sat), up to 4 meals, workshops & activities
- Adult (18+): $90
- Youth (4 -17): $70
- Child (0-3): FREE
SATURDAY ONLY: up to 3 meals, workshops & activities
- Adult (18+): $60
- Youth (4 -17): $50
- Child (0-3): FREE
Prices increase each month. Additional camp information: peacelifecenter.org/peacecamp
Registrant Name (must be at least 18)*

FIRST NAMELAST NAME
Registrant Email*
EMAIL TO SEND COMMUNICATIONS ABOUT CAMP
Registrant Phone Number*
Please enter a valid phone number.
Registrant Address*

Street Address

Street Address Line 2

CityState

Zip Code
Total Number of ADULTS*
Adult Option (18 and older)*

ADULT FULL WEEKEND WAITLIST*ADULT SATURDAY ONLY WAITLIST*
Select the meals you intend to to be present for (take into account arrival/departure times, along with planned hikes)

Friday Dinner (6-7pm)Saturday Breakfast (8-9am)Saturday Lunch (12-1pm)Saturday Dinner (5-6pm)Sunday Breakfast (8-9am)
Estimated Time of Arrival (FYI- earliest Friday arrival is at 3pm, dinner is at 6pm)

AM/PM Option
Additional Adult Names (18 and older). Please note that if no additional email is listed here, only the registered adult will receive camp information and updates.*
Number of YOUTH (age 4-17)*
Youth Option (Age 4-17)*

YOUTH FULL WEEKEND WAITLIST*YOUTH SATURDAY ONLY WAITLIST*
Youth Names (Age 4-17)*
Number of CHILDREN (Age 3 and under)*
Child Option (Age 3 and under)*

CHILD FULL WEEKEND WAITLIST*CHILD SATURDAY ONLY WAITLIST*
Child Names (Age 3 and under)*
Special Requests

I have a special need or request for cabin assignmentI will be bringing a trailer or a tent to sleep inI have dietary restrictions (Allergies or Food Preferences)I would like to apply for a 50% OFF registration fee scholarshipI NEED or can OFFER a ride to camp
OFFER or NEED a ride*
Names of those with Dietary Restrictions (Vegan, Gluten Free, Allergies, etc.)
Comments for special requests*
Scholarship Requests

You have indicated that you are in need of a 50% off scholarship. We will respond to your request within 5 business days and let you know the final total due. (FYI- requests are rarely declined =)). Feel free to skip the payment portion below until we contact you. If you have any questions, please contact PeaceCamp209@gmail.com.
Would you like to make a voluntary donation towards Peace Camp Scholarships?*

YesNo
Camp Scholarship Donation Amount:
Thank you for your donation! These donations are given to those who indicate they need for a scholarship.
Total Number of Campers
(THIS IS AN AUTOMATED FIELD)
Total $'s for Adults
(THIS IS AN AUTOMATED FIELD)
Total $'s for Youth
(THIS IS AN AUTOMATED FIELD)
Camp Registration Fee:
(THIS IS AN AUTOMATED FIELD- pay this amount if you're paying with cash or check)
TOTAL DUE:
(THIS IS AN AUTOMATED FIELD- PLEASE INSERT AND PAY TOTAL DUE AMOUNT BELOW)
Payment

CREDIT CARD: If paying by credit card, please input the "Total Due" shown above into the pay by credit card box below. CHECKS: If sending a check, please select the additional payment option below that says you prefer to send a check. Checks may be sent to the Modesto Peace/Life Center, 829 13th Street, P.O. Box 134, Modesto, CA 95353-0134.

Pay by Check

I prefer to send a check to Modesto Peace/Life Center, 829 13th Street, P.O. Box 134, Modesto, CA 95353-0134. Please note the "TOTAL DUE" listed above, minus the credit card fees.
TERMS AND CONDITIONS:

By signing below, I understand that my registration is not valid until full payment is received by the Modesto Peace/Life Center. To be eligible for any discount, my payment must be received by the listed due dates. Mailed checks must be postmarked by the due date to receive any applicable discount.

I understand that the Medical and Photo Release form is required for all campers. I will follow the link I receive in my confimation email and submit this form.
Signature*
Should be Empty:

40th Annual Peace Camp Registration

Scholarship Requests

Payment

Credit Card