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Before registering online:
Please note there is an approximate 3% convenience fee to process transactions for online registration payments.
**Please note that camps will be taken off of the online registration 2 weeks prior to the start date of camp.
Online Registration
*
Indicates required field
Camp Attending
*
Older Midler (July 30-August 2)
Name
*
First
Last
Home Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Gender
*
Male
Female
First Time Camper
*
Yes
No
Date of Birth
*
MM/DD/YYYY
Grade in Fall 2019
*
County your Child Attends School
*
Special Needs
*
Yes
No
If yes, explain:
*
Church
*
Association
*
Pastor's Name
*
Parent or Guardian if Camper is under 21
*
First
Last
If address is different than above please provide the address of Parent or Guardian.
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Home Phone
*
Work Phone
*
Cell Phone
*
Do you give your child permission to swim in the river with lifeguard supervision?
*
Yes
No
Do you give permission for photographs to be taken during the camp and used for promotional purposes?
*
Yes
No
Submit
Health Form
