2017 SIT Participant Application
The application below should be full completed by the SIT camper. If you have any questions regarding the application or the program please contact Ava, program director at program@agapekurebeach.org or 919-552-9421.

All SIT campers still need to complete the regular summer camper registration form found on the website. This registration and the required deposit must be completed to be fully registered for the program.

Please select program
Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Home address
Your answer
Home phone or Parent Cell Phone
Your answer
Camper cell phone
Your answer
Camper email address
needs to be something you check regularly. If you do not have an email address you check regularly please list your parent's email and mark it as (parent). ex- camper.mccamperson@gmail.com (parent)
Your answer
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