2019 Southside Christian Camp Camper Application

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Email *

Thank you for filling out the online application for 2019! Please note that a signed copy of the application and payment of $100 is due at Southside Church of Christ before your camper's spot is reserved. Applications received BEFORE MAY, 31 2019 are eligible for a $10 discount. Please print and sign the physical application here (https://drive.google.com/file/d/1Mpf27JQzmq-DarrTDjhffHhg-YyLudK2/view?usp=sharing)

First Name *

Last Name *

Gender *

Female

Male

Date of Birth *

YYYY

Grade Completed May 2019 *

T Shirt Size *

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult XL

Other:

Current Address *

Parent / Guardian Name *

Phone Numbers *

Parent / Guardian Email Address

Additional Contact (Relation and phone number)

Home Congregation

Will you need transportation to and from camp? *

Yes

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