Clone of 2026 Chihowa Family Camp (Credit Card)

Use this form to pay the Registration Fee by Credit Card. Use the other form to pay by Cash or Check.
Family Information
Family Name
How many people are you registering?*
Select up to 5. If you need to register more than 5 people, please submit additional registration forms.
Family Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Congregation*
I'm attending as a friend of:
Main Lodge - UpstairsMain Lodge - DownstairsLake LodgeRV SpaceTent SpaceI (We) will not be spending the night
Length of RV or Tent Size
Do you have any room requests or comments? (Roommate preference, Adult/Family sponsor, certain days attending, etc.)
Are there certain classes, activities, or events you would like to help with?
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc.?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medications?
Have you recently been exposed to a contagious disease or illness?
Do you have any special dietary needs?

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc.?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medications?
Have you recently been exposed to a contagious disease or illness?
Do you have any special dietary needs?

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc.?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medications?
Have you recently been exposed to a contagious disease or illness?
Do you have any special dietary needs?

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc.?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medications?
Have you recently been exposed to a contagious disease or illness?
Do you have any special dietary needs?

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc.?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medications?
Have you recently been exposed to a contagious disease or illness?
Do you have any special dietary needs?

Payment