Camp Blue Diamond Summer Camp Registration 2019
We look forward to seeing you this summer at Camp Blue Diamond!

Online Registration requires your child's medical and insurance information. Please have that information ready.

Registering online, also requires payment of the final balance with a credit or debit camp.

If you would like to request scholarship aid, or make extended payments, you'll need a CBD Summer Camp Registration Form. To receive this form contact Camp Blue Diamond, or print one from the website: www.campbluediamond.org.

If you are registering more than one child, complete an online registration for each child.

If you are registering for Family Camp or a Kiddie Camp, only do one online registration for all people attending that camp.

If the camp you want is not listed as a choice, it is closed because of full enrollment.

If you have any questions, please contact us at:
Camp Blue Diamond
P.O. Box 240, 4013 Blue Diamond Dr., Petersburg, PA 16669
Ph.: (814) 667-2355 / Email: campbluediamond@verizon.net / Website: campbluediamond.org

Camper's Last Name *
Your answer
Camper's First Name *
Your answer
Camper's Middle Initial
Your answer
Grade *
Current grade level - the one he/she is completing in the Spring of 2019
Street Address or P.O. *
Your answer
City *
Your answer
State *
Use postal abbreviation (examples: for Pennsylvania use PA, for New York use NY)
Your answer
Zip *
Your answer
Gender *
Birth Month *
Birth Day *
Birth Year *
Age at time of camp *
Is this 1st time attending CBD as a summer camper? *
Congregation
Name of Person Completing This Online Registration *
Your answer
Parent/Guardian's Name *
Your answer
Email *
Frequently checked Parent's email address
Your answer
Parent/Guardian Address if Different from Camper
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Please Email my Confirmation Packet *
If you choose 'No' your Confirmation Packet will be mailed to your home address
Emergency Contact Name *
Please give the name of an adult who can serve as an emergency contact, in the event camp needs to contact the parent/guardian, and she/he is unavailable. Emergency Contact may be another parent if parents not living together.
Your answer
Relationship to Camper
Your answer
Emergency Contact's Phone Number *
Your answer
Emergency Contact's Work Phone Number
Your answer
Is the Emergency Contact a Second Parent *
If the Emergency Contact is a parent at a different address, please mark 'Yes".
Name of Step-Parent at this Address
Your answer
Are there circumstances regarding custodial relationships camp needs to be aware of before releasing a child to a parent?
If 'Yes' to previous question, please explain:
Your answer
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