AMPLIFY Winter Retreat 2022 (Feb 25-27)

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**PLEASE READ BEFORE BEGINNING**
1. REGISTRATION MUST BE COMPLETED BY THE CAMPER'S PARENT OR GUARDIAN.
2. Be sure to check with your youth pastor to know which weekend your church is attending.
3.Please register each camper individually and have insurance cards available.
4. Once submitted, please complete Step 2- Payment to finalize registration.

Email *

Camper First Name *

Camper Last Name *

Grade *

Date of Birth *

YYYY

Gender *

Male

Female

T-Shirt Size *

(Adult sizes.)

2XL

3XL

Home Church *

Roommate Requests

(You may list individuals or church or youth groups. No guarantees. Counselor requests are not considered.)

Address *

City *

State *

Enter 2 digit State code (all caps)

Zip *

Student Cell Phone

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