2024 Middler Camp

June 2 - 5, 2024 (Sunday - Wednesday)

For Students entering 3rd & 4th grade

Cost: Before or by May 27th price is $160.00, May 28th price is $175.00.

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Email *
Camper's First Name *
Camper's. Last Name *
Camper's Preferred Name
Address *
City *
State *
Zip code *
Phone Number with Area Code (format: 555-777-9999) *
Date of Birth *
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/
DD
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Grade in Fall 2024
 *
Gender *
Parent/Guardian Name(s) *
Main Contact Phone Number *
Emergency Contact Full Name (other than Parents) *
Emergency Contact Phone Number *
Additional Contact Information, if necessary. Please include additional information that may be helpful for camp staff such as persons NOT allowed to pick up the camper. [Skip if not applicable.]
Name of Church Camper attends [Please include City.] *
Person(s)/Church (other than parents) designated to take camper from camp. [IMPORTANT: ONLY the person(s)/church designated will be permitted to take the camper from Camp of the Good Shepherd premises during or following their camp.] *
Camp T-shirt *
A FREE 2024 Camp T-shirt will be given to each student camper. Additional T-shirts may be purchased at camp. Please indicate T-shirt Size of camper:
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