2022 Lakeview Camper Registration
Thank you for your interest in Lakeview Christian Camp's 2021 Summer Season!

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

Please pay as soon as you have finished registering by mailed check, or by going to our website and paying with your card through PayPal.

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.
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Email *
CAMPER Information
What is the CAMPER'S First Name? *
What is the CAMPER'S Last Name? *
What is the Camper's Gender? *
What is the Camper's Date of Birth? *
What Grade will the Camper enter in Fall 2022? *
What camp are your registering the camper for? *
What is the Camper's T-Shirt Size? *
Camper's Mailing Address
What is the Camper's Street Address? *
What is the Camper's City? *
What is the Camper's State? *
What is the Camper's ZIP Code? *
What is the Camper's Primary Phone? *
(Include Area Code)
What is the Camper's Email Address? *
Please select the church with which you are attending (if any) *
If other, please list:
How did you hear about camp this year?
(check all that apply)
If other, please specify:
Mother/Parent/Guardian 1
First Name *
Last Name *
Home Phone
Cell Phone
Work Phone
Primary Phone? *
Email address *
This is the email address that will receive your registration confirmation. If none, write "none."
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)
Mother/Parent/Guardian City (if different)
Mother/Parent/Guardian 1 State (if different)
Mother/Parent/Guardian 1 ZIP (if different)
Father/Parent/Guardian 2 Information
First Name
Last Name
Home Phone
Cell Phone
Work Phone
Primary Phone
Clear selection
Email Address
If none, write "none"
Is mailing address the same as the camper's?
If yes, you do not need to fill in the information again.
Clear selection
Father/Parent/Guardian 2 Street Address (if different)
Father/Parent/Guardian 2 City (if different)
Father/Parent/Guardian 2 State (if different)
Father/Parent/Guardian 2 ZIP (if different)
Non-Household Member Emergency Contact Information
Please enter emergency contact information for someone not living in your household.
Emergency Contact Name *
Emergency Contact Phone *
Relation to Camper
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?
Any Person(s) NOT allowed to pick up child from camp?
Clear form
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