Summer Camp Registration
Event Timing: Summer 2022
Event Address: Camp Bethany, 5774 Twp. Rd. 212, Lakeville, OH 44638
Contact us at (330) 669-2267 or sbrethren@earthlink.net
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Week of Camp *
I Am Registering Through the Following Church *
Required
Camper's First Name *
Camper's Last Name *
Camper's Birthday *
MM
/
DD
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Grade in School Camper Has Most Recently Completed
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Parent's First Name *
Parent's Last Name *
Student's Street Address *
Student's City *
Student's State *
Student's Zip *
Parent's Phone Number *
Email *
Organization *
What days will you attend? *
Required
Dietary restrictions *
I understand that I will have to pay $$ upon arrival *
Required
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