Camp Bethel (Fincastle, VA) Summer Camp Registration Form 2021
THANK YOU for choosing Summer Camp at Camp Bethel in Fincastle, VA!  Our programs are open to everyone regardless of race, color, national origin, gender, or disability where accommodations can match needs.

This is our NEW and IMPROVED shortened Registration Form. There are fewer questions to complete on this initial form, with more detailed questions on your follow-up "Camper Health and Info Form" which is due 1 month before your camper's selected week. We will send you a confirmation e-mail in April or May with a link to your Confirmation Packet and an on-line Camper Health and Information Form to complete. Add "CampBethelOffice@gmail.com" to your contacts so you will receive our email..

The final item on this Registration Form is your "Parent/Guardian and Camper Agreement" which includes our Good Behavior Requirement and your Parent/Guardian Authorizations for Attendance. (Consider: Is a Camp Bethel program a good fit for your camper? She/he will be with other children/youth and their counselors all day each day. We stay together with our group during our entire time at Camp Bethel. Bad behavior does not fit and cannot be tolerated.) By requesting enrollment into Camp Bethel programs, you and your camper agree and understand that good behavior is required. See www.CampBethelVirginia.org/ParentInfo for details.

This form works best on a laptop or desktop. If using a mobile device, please use correct capitalization, and be careful with tricky pull-down menus.

SCROLL THIS FORM DOWN AS YOU GO, and be sure to click the SUBMIT button at the bottom of the form!  Items with a red * asterisk are REQUIRED items.
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Camper's FIRST name *
REQUIRED. Thank you for using correct capitalization for names and titles throughout this registration form.
Camper's LAST name *
REQUIRED. Thank you for using correct capitalization for names and titles throughout this registration form.
Name Camper prefers to be called
Gender - male or female *
REQUIRED QUESTION.
Camper birth date *
REQUIRED QUESTION:  month / day / year; MM/DD/YYYY; examples: 3/9/2004  or  12/18/2012
Age at camp *
REQUIRED QUESTION.  When your child comes to camp, what will her/his age be?
Grade (fall 2021) or age-grade equivalent *
REQUIRED QUESTION.  Generally, Campers are grouped with their same age-grade equivalent, (as well as their chosen cabin mate).
Cabin mate(s) requested or Unit Friend(s) for friends of different genders
Your chosen friend MUST be signed up for the same week and program. Units are generally grouped by same age/grade and cabins are grouped by gender plus age/grade, (as well as your chosen cabin mate/unit friend).
Mailing address *
REQUIRED QUESTION:  Number and Street, or PO Box (including apt #).  Thank you for using correct capitalization.
City *
REQUIRED QUESTION.  Thank you for using correct capitalization.
State (2-letter postal abbreviation) *
REQUIRED QUESTION.  Please use the correct 2-letter postal abbreviation for your state.
Zip Code *
REQUIRED QUESTION.  Please enter your 5-digit zip code.
FIRST NAME(s) of custodial Parent(s)/Guardian(s) who are the primary contacts for this camper. *
REQUIRED QUESTION.  These are the parent(s)/guardian(s) with whom the camper has primary residence and to whom we send camper information in care of.  Example: Jane and John
LAST NAME(s) of custodial Parent(s)/Guardian(s) who are the primary contacts for this camper. *
REQUIRED QUESTION.  These are the parent(s)/guardian(s) with whom the camper has primary residence and to whom we send camper information in care of.  Example: Doe
Family e-mail *
This is where we will e-mail your confirmation packet and camp preparation information. In emergency, we will also send important information by e-mail to this address. (We'll also CALL you in case of extreme emergency).
Main phone/Cell phone of custodial Parent/Guardian *
include area code, number, and name, (ex: 540-555-1234  Jane Cell)
Work or other reliable phone of custodial Parent/Guardian
Include area code, number, and name, (ex: 540-555-1234  John Work). In case we can't reach you by your cell phone.
Summer Camp Program Choice
From the pull down menus, select your DATES and your PROGRAM TITLE.  Notes: Parent-Child Overnight Camp requires answering two additional questions.
During Which Dates does your chosen program occur? REQUIRED QUESTION. *
(Forget the exact dates of your chosen program?  Open another window/tab in your browser and check for an e-mail from PayPal confirming your payment AND the Camp Program Title and Dates for which you paid.)
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