Confirmation Camp Registration for Pastors

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Email *

PLEASE NOTE: COVID policy is provisional and may change before summer camp.

Pastor Information

First Name *

Last Name *

Gender *

Home Congregation & City

Home Address (Include Street Name, City and Zip) *

Emergency Contact (Name & Relationship) *

Emergency Contact Main Phone *

Emergency Contact Email *

2022 Summer Camp Dates

Which week will you be attending? The cost for a week of summer camp is $250. A $100 non-refundable deposit is due when registering. *

July 10 - July 15 (Sun - Fri) Luther Glen Farm: Confirmation Camp

Health Information

Does you have any allergies? Please let us know if the allergy is airborne and the details on its severity. If none, type 'none'. *

Does you have any dietary restrictions? If none, type 'none'. *

Activity Release Waiver

I hereby give permission for myself to participate in the programs and all activities of Lutheran Retreats, Camps & Conferences. Programs and activities include but are not limited to hiking (easy to moderate levels), rock wall climbing (easy to moderate), archery, swimming (levels determined by swim test administered on site) and other outdoor activities that will vary based on the participants abilities. I agree LRCC will not be held responsible for accidents or personal injury arising there from. I give the camp staff permission to seek medical treatment for my family in case of illness or injury. *

Authorization

Required

I have read and agree to the terms and conditions above. By signing this form I give LRCC permission to charge my account the deposit amount due of $100 indicated on my registration form. *

Yes

Required

Photo Use Waiver

Your photo may be taken for use in camp promotional literature this summer. You would only be identified as a pastor, not by name. You can either allow us to use photos of you, but waive the right to inspect or approve the photo if used for such purposes, or prohibit the camp from using your photo. *

Yes, you may use photos of me

No, you may not use photos of me

Required

Payment

Your payment information will remain private and confidential.

How will you be paying? *Your reservation will be confirmed upon receipt of your payment. *

Credit/Debit Card

Check (Please mail to LRCC Summer Camp, 39136 Harris Road, Oak Glen, CA 92399)

My Church Will Pay

Name on Card

Card Number

Expiration Date

Billing Address (Include Street Name, City and Zip)

Please select the amount being paid today

$100

$250

My Church Will Pay

Clear selection

A copy of your responses will be emailed to the address you provided.

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