Winter Camp Registration

Group Registration Form

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 13 - 15 January 27 - 29

Estimate how many Males (students and chaperones) We suggest two chaperones per room. Final numbers are due 10 days prior to event. $64 Student/$29 Adult *

Estimate how many Females (students and chaperones) We suggest two chaperones per room. Final numbers are due 10 days prior to event. $64 Student/$29 Adult *

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

Submit