Extreme Faith Camp 2019 - Participant Reg.
June 24 - June 28 2019

Deadline to register is April 1, 2019
$150 Deposit is due at the time of registration.

Open to all CURRENT 7th and 8th Graders

**ATTENTION: Please note that we are at our maximum for FEMALE campers at this time, until we can confirm another adult chaperone. If are registering a female camper you will be put on a wait list.**

Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
Address *
Your answer
Home Phone Number *
(xxx)xxx-xxxx
Your answer
Parent's Cell Phone *
(xxx)xxx-xxxx
Your answer
Teen Cell Phone
(xxx)xxx-xxxx
Your answer
Parent's Email Address *
Your answer
Teen's Email Address *
Your answer
Emergency Contact
In the event of an emergency, if you are unable to contact me at the above numbers please contact:
Emergency Contact Name *
Your answer
Relationship *
Your answer
Primary Phone *
Your answer
Secondary Phone *
Your answer
Special Considerations
My Child has special dietary restrictions
If yes please describe
Your answer
Once you submit your registration you will be asked to follow a link to payment page. Your registration is not complete until a deposit has been received.
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