2018 Lakeview Camper Registration
Thank you for your interest in Lakeview Christian Camp's 2018 Summer Season!

Please have a parent or guardian 18 years of age or older fill out this registration form in its entirety.

If you have any questions while filling out the form, you may call the camp office at 785-425-8558 or email the registrar: registrar@lakeviewchristiancamp.org.

There is no need to print any of this information out to bring with you to camp. We are using a 100% electronic registration process.

CAMPER Information
What is the CAMPER'S First Name? *
Your answer
What is the CAMPER'S Last Name? *
Your answer
What is the Camper's Gender? *
What is the Camper's Date of Birth? *
MM
/
DD
/
YYYY
What Grade will the Camper enter in Fall 2018? *
What camp are your registering the camper for? *
CAMPS ARE BASED ON GRADE ENTERING IN FALL 2018
Camper's Mailing Address
What is the Camper's Street Address? *
Your answer
What is the Camper's City? *
Your answer
What is the Camper's State? *
Your answer
What is the Camper's ZIP Code? *
Your answer
What is the Camper's Primary Phone? *
(Include Area Code)
Your answer
What is the Camper's T-Shirt Size? *
Please select the church with which you are attending (if any) *
If other, please list:
Your answer
How did you hear about camp this year?
(check all that apply)
If other, please specify:
Your answer
Mother/Parent/Guardian 1
First Name *
Your answer
Last Name *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Primary Phone? *
Email address *
This is the email address that will receive your registration confirmation. If none, write "none."
Your answer
Is mailing address the same as camper? *
If mailing address is the same, select yes. You do not need to fill in information again.
Mother/Parent/Guardian 1 Street Address (if different)
Your answer
Mother/Parent/Guardian City (if different)
Your answer
Mother/Parent/Guardian 1 State (if different)
Your answer
Mother/Parent/Guardian 1 ZIP (if different)
Your answer
Father/Parent/Guardian 2 Information
First Name
Your answer
Last Name
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Primary Phone
Email Address
If none, write "none"
Your answer
Is mailing address the same as the camper's?
If yes, you do not need to fill in the information again.
Father/Parent/Guardian 2 Street Address (if different)
Your answer
Father/Parent/Guardian 2 City (if different)
Your answer
Father/Parent/Guardian 2 State (if different)
Your answer
Father/Parent/Guardian 2 ZIP (if different)
Your answer
Non-Household Member Emergency Contact Information
Please enter emergency contact information for someone not living in your household.
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Relation to Camper
Your answer
End of Camp Information
If left blank, the person bringing the camper to camp will be the one the camper will be expected to leave with.
Person or Church designated to pick up camper from camp?
Your answer
Any Person(s) NOT allowed to pick up child from camp?
Your answer
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