Event registration
Event Timing: May 25 - 27, 2018
Event Address: Mount Hermon - Ponderosa Lodge
Contact us at 408-265-5374 or email: cfenn@dsj.org

Paying with cash/check:
Adults (18+) -- $225
Children (4-17) -- $135
Children (0-3) -- FREE

Paying by card in the office:
Adults (18+) -- $231
Children (4-17) -- $139
Children (0-3) -- FREE

$100 non-refundable deposit due to secure registration

More information can be found at Holy Family's website: https://holyfamilysanjose.org/radiate-family-camp

First Name *
Your answer
Last Name *
Your answer
Email *
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Dietary restrictions *
Birthdate *
MM
/
DD
/
YYYY
Shirt Size
Medical Plan Name *
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Policy Number *
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Medical Plan Address *
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Medical Plan Phone Number *
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Primary Subscriber Name *
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Subscriber's workplace *
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Dentist
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Preferred Hospital
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Doctor's Name *
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Doctor's Phone Number *
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Parish *
Required
Will a spouse be with you?
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