Camp Blue Diamond Summer Camp Registration 2017
Help us make this the best summer camp experience you ever had, by completing all the required fields. We look forward to seeing you at CBD! If a camper is registering for more than one camp, complete a 2nd online registration after this one. If you are registering more than one child, complete an online registration for each child. If you are registering for Family Camp only do one online registration for the whole family. 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 / 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 2017
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
Parent/Guardian
Your answer
Email
Frequently checked Parent's email address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Other Phone
Your answer
Please Email my Confirmation Packet
If you choose 'No' your Confirmation Packet will be mailed to your home address
Other Information:
Please share information that will helpful for the counselor to know about your child prior to camp.
Your answer
Camp Sessions - First Choice
If a camp is not listed, it has been closed due to full enrollment.
Roommate Request
Your child may request 1 roommate. The child you request must also request you.
Your answer
Camp Sessions - Second Choice
Your child will be registered for this camp, only if the first choice camp is already full. If a camp is not listed, it has been closed due to full enrollment.
Roommate Request - 2nd Choice Camp
Your child may request 1 roommate. The child you request must also request you.
Your answer
Family Camp Information
If attending Family Camp, please list all adults and children (with ages) attending.
Your answer
Total Fee:
List the total $ amount of your 1st Choice Camp
Your answer
Congregational Support
Middle PA District Church of the Brethren churches and Center Association Baptist churches provide stipends for member campers
Congregation Amount
Put the $ amount your church will pay.
Your answer
Sibling Discount
Discount for camper whose sibling(s) is (are) also attending CBD summer camp.
Sibling(s)
List Sibling(s) attending CBD Summer Camp
Your answer
CIT Camp Discount
Discount 1/2 the CIT Camp fee if this camper is also attending a Sr. High age camp as a camper. (Includes Youth Camp, Yough Adventure, Bike and Raft Adventure, Sr. High Canoe.)
Your answer
Balance:
List the amount owed after deducting any church stipends, sibling discounts or CIT discounts:
Your answer
Type of Credit/Debit Card
Online registration requires the entire balance be paid by credit or debit card. If you prefer to make extended payments or would like a camp scholarship go to campbluediamond.org or a Summer Camp Registration Form.
Expiration Date - Month
Expiration Date - Year
Card Number
Put hyphens or spaces between each set of numbers; otherwise, it may not process and registration will be delayed.
Your answer
Name as it appears on Card
Your answer
Parental Permission
I give permission for Camp Blue Diamond to photograph and video my child. Use of photos and videos will be limited to camp publications including: the website, newsletters, summer video, group photos and promotional information including Facebook. Your child will not be identified in the publications.
Camper/Parent Agreement
The camper registering agrees to abide by all regulations concerning personal conduct and use of camp property. Should it become necessary for the camper to return home, the parents/guardians will abide by camp's decision and provide transportation.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms