Cedar Lake Ministries Winter Camp 2020 Registration Form
PLEASE COMPLETE ALL FIELDS
First and Last name *
Your answer
Date Attending *
T-Shirt size: *
Date of Birth *
MM
/
DD
/
YYYY
Student or Leader *
Gender: *
Required
Are you actively involved with a local church? If so, what is the name of the church?
Your answer
Church/Group Attending With *
If not attending with a Church/Group enter "N/A"
Your answer
Student's parent/guardian name(s): *
Your answer
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Phone Number: *
Your answer
Emergency Contact: *
Your answer
Emergency Contact Phone: *
Your answer
Parent/Guardian or Leader Email: *
Your answer
I'd like to receive the E-Newsletter
Registration Form Cost per Student: $135 Please give registration form and make all payments to church or group attending with.
Need financial assistance? Download scholarship application at: https://www.cedarlakeministries.org/winter-camps/
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