Virginia Youth Camp - 2025 - Pre-Teen Registration

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Youth Camp (Ages 7-12): June 21-28

Please enter the Parent / Guardian Email below

Email *

Parent / Guardian Name *

Parent / Guardian Phone *

Emergency Contact Phone *

Camper's First Name *

Camper's Last Name *

Camper's Email (if they have one)

Date of Birth *

YYYY

Address *

Sunday School Attended *

Health Insurance Provider

Health Insurance Policy Number

Medications, Allergies, or Special Needs

Permission to Treat *

I give my permission for any needed medical attention and will be responsible for any expenses. The Virginia Christadelphian Youth Camp does not carry supplemental health insurance.

Required

Tuition

Tuition is $50 per camper (there is a $120 max per family per year). Please make checks payable to Christadelphian Youth Camp and bring on the first day of camp.

A copy of your responses will be emailed to the address you provided.

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