Student Information
Teen Camp 2019 June 24- 28th  COST $ 175  (give payments to your local church, one church check is sent )

Registration 2:00- 4:30 pm  Departure 12:00 pm    

Payments from churches postmarked by June 3rd,  all registrations after that point must include $25 late fee

Registration closes on June 16th

We are praying for you and super excited that you are attending!
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Full Name *
Address *
City, State, Zip *
Cell Phone (at camp) *
E-Mail Address *
Home Church (Do not put 1st) *
Youth Pastor/Pastor Name *
Youth Pastor/Pastor E-mail *
Grade (just completed, by camp) *
Age (as of camp) *
Birthdate *
MM
/
DD
/
YYYY
Gender *
T-Shirt Size *
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