Youth Camp Registration 2024
July 22-26, 2024 Check-in begins at 3:00 pm on Monday and concludes after lunch on Friday

Contact Camp Program Director with any questions - Angela Bray 651.235.7414
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Email *
Name *
Address *
Date of Birth *
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Gender *
Grade Completed Spring 2024 *
Parent Phone Number *
Address *
Student Email
Home Church *
Previous Camp Experience
Dietary restrictions *
Please list all health concerns that we should be aware of as well as allergies or activity restrictions. All medications MUST be turned into the Camp Director upon arrival to camp, and be in original container with dosing information on  label from prescriber.   *
EMERGENCY CONTACT INFORMATION -Please list 2 phone numbers *
Insurance Company & Policy Number *
I give my consent for my child to attend camp and to participate in the programming, including activities like swimming, boating, kickball, etc. I will not hold the camp, personnel, or sponsoring organizations responsible beyond reasonable supervision. All activities are supervised by qualified adult leaders. I understand that if campers do not comply with rules and regulations they may be asked to return home at the cost of their parents. I give my consent for routine and non-surgical medical care, and if necessary, emergency medical or surgical treatment of my child, in the event I cannot be reached to give my consent. I understand my typed name constitutes my signature on this form. *
I give my consent for photos/videos of my child to be used for print and digital promotion. *
Youth Camp is $295. We are offering a Tier #2 price of $225 for those families struggling at this time. Tier #2 pricing is subsidized by generous donations to the camp ministry!  Scholarships are available through your local church or through the Josh Lillo Memorial Scholarship Fund. Reach out to your pastor or Angela for more information. *Registration will not be considered complete until the registration fee has been received. Registrations must be received by JULY 1 *
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