Retreat-Spring

1
CAMPER'S NAME* This field is required.
First Name
Last Name
2
GRADE* This field is required.SELECT THE GRADE YOU ARE CURRENTLY IN
Please Select
Please Select
6th
7th
8th
9th
10th
11th
12th
Chaperone
Chaperone - w/younger child
3
For STAFFING purposes only.ONLY CHAPERONES NEED TO ANSWER THIS QUESTON
TYPE CHURCH YOU ATTEND AND THE CAMP SESSION YOU ATTEND.
4
PHONE NUMBER* This field is required.
Please enter a valid phone number.
5
EMAIL ADDRESS* This field is required.SUBMIT A GOOD CONTACT EMAIL ADDRESS
example@example.com
6
EMERGENCY CONTACT* This field is required.
First Name
Last Name
7
EMERGENCY CONTACT PHONE* This field is required.SUBMIT A GOOD EMERGENCY CONTACT NUMBER
Please enter a valid phone number.
8
PAYMENT* This field is required.CHOOSE ONE PAYMENT OPTION
PAY WITH VENMO
Pay $45.00 CASH/CHECK @ CAMP
9
Image Field
Should be Empty: