Winter Camp Registration

Group Registration Form

* Indicates required field

Your Name *

First

Last

Group or Church Name. If registering your family, please put last name. *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number - Best number to contact you. *

Pick your Weekend *

January 11 - 13, 2019 January 25 - 27, 2019

Estimate how many Males (students and chaperones) We suggest two chaperones per room. Final numbers are due 10 days prior to event. $70 Student/$35 per adult chaperone (1 per 10 students) additional adults are $55. *

Estimate how many Females (students and chaperones) We suggest two chaperones per room. Final numbers are due 10 days prior to event. $70 Student/$35 per adult chaperone (1 per 10 students) additional adults are $55. *

List any food allergies or special diets the camp will need to know. *

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