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Jackson Park Church of Christ Camp Meribah Application
Cost per camper is $90 if application turned in no later than May 7th
Cost increases to $110 if application turned in AFTER May 7th
Get your application in and save money.

Campers love mail!
Mailing Address:
138 North Central Avenue
Centerville, TN 37033

Email address
Camper’s Name:
Friend of:
Last grade completed (completed 3rd-12th grade only):
Street Address:
City, State, Zip:
T-Shirt Size:
Date of Birth:
MM
/
DD
/
YYYY
Gender:
Parent/Guardian name:
Parent/Guardian phone:
Parent/Guardian email address:
Please mark the activities your camper wants and has permission to participate in (check all that apply):
Required
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This form was created inside of Jackson Park Church of Christ. - Terms of Service - Additional Terms