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Virginia Youth Camp - 2024 - Teen Registration
Week Two of Youth Camp (teens): August 3-10
Please enter the Parent / Guardian Email below
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Email
*
Your email
Parent / Guardian Name
*
Your answer
Parent / Guardian Phone
*
Your answer
Emergency Contact Phone
*
Your answer
Camper's First Name
*
Your answer
Camper's Last Name
*
Your answer
Camper's Email (if they have one)
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Address
*
Your answer
Sunday School Attended
*
Your answer
Health Insurance Provider
Your answer
Health Insurance Policy Number
Your answer
Medications, Allergies, or Special Needs
Your answer
Permission to Treat
*
I give my permission for any needed medical attention and will be responsible for any expenses. The Virginia Christadelphian Youth Camp does not carry supplemental health insurance.
Required
Tuition
Tuition is $50 per camper (there is a $120 max per family per year). Please make checks payable to Christadelphian Youth Camp and bring on the first day of camp.
A copy of your responses will be emailed to the address you provided.
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