2012 Summer Camp Registration Form

REGISTRATION INFORMATION

The camp grade level is based on the grade the camper completes in June 2012. For instance, a camper who will complete 4th grade may register for 3rd-4th grade camp.
Once registration has been received and processed whether online or mail in a confirmation will be emailed (mailed if no email provided).
If you do not receive a confirmation please contact the camp office.
To receive earlybird pricing entire balance must be paid on or before deadline of March 9th for Leadership/Confirmation Camps and May 5th for other camps.
Cancellations made prior to two weeks before your session are eligible for a full refund (minus the $100.00 non-refundable deposit).

Camper Name Camp Session

Gender: Birth Date Grade Completed June 2012

Church attending Church Town

Camp Cost:

Adult Contact for this registration

Address:

City State Zip Code:

Phone: Email*:

*this is the email that important camp information will be sent to

PAYMENT INFORMATION

Early bird pricing ends March 9th, 2012 for Leadership/Confirmation Camps and May 5th, 2012 for other camps.

Camp Session Cost $

If camper or camper family members are attending multiple youth camp sessions, deduct $15 for second and subsequent sessions:

Multi Session Discount

Camp T-Shirt - each session has a different shirt – additional $10.00

T-shirt size:

Church will provide: $ campership. Church Contact Person

There are a limited number of Presbytery camperships available. Contact the camp office to inquire about one.

Amount to be charged $

Credit Card Information on next page

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