"12 Days of Camp Bethel" Registration Form
In place of our winter program, we will be sending out (via post mail) a "12 Days of Camp Bethel" themed box to our camper families free of charge.  This box will arrive around Christmas and will include an activity booklet, activity supplies, stickers, and more!  To receive your box please complete the form below!

Camp Bethel (Fincastle, VA) programs are open to everyone regardless of race, color, national origin, gender or disability.  Once you have submitted your registration, click the SUBMIT button at the bottom.  Required questions have a red "*" asterisk.
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Camper's LAST name *
Thank you for using correct capitalization and punctuation throughout this form!
Camper's FIRST name *
Thank you for using correct capitalization and punctuation throughout this form!
Camper's Middle Initial
Gender - male or female *
Grade (2020-2021 school year) or grade equivalent age group *
Camper birth date *
month / day / year; example: 03/09/1999
Mailing address including street or PO Box *
Thank you for using correct capitalization and punctuation throughout this form!  Thank you!
City *
State *
Note that VA is the first choice.
Zip Code *
Full Name of custodial Parent(s)/Guardian(s) who is the primary contact for this camper. *
This is the parent/guardian(s) with whom the camper has primary residence and to whom we send camper information in care of.  Example: Jane and John 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 CALL you in case of extreme emergency).
Main phone/Cell phone of custodial Parent/Guardian *
include area code, (ex: 540-555-1234)
How did you learn about Camp Bethel?
Church Membership
... if any.  (this is NOT required for camp attendance, and ALL children/youth are welcome in our summer camps.)  If you are from a Church of the Brethren congregation, PLEASE answer this question.
Pastor
... if any.  (this is NOT required for camp attendance.)
Once you hit "submit," you will be given a link to our online payment page for donations.  We are offering our "12 Days of Camp Bethel" box for FREE, however, we welcome donations for the supplies and postage! Thank you!  Now, CLICK SUBMIT!
If you do not click "Submit" we will not receive your camper's information.
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