Poiema Application Form
Hello! We are excited you have decided to apply for Camp of The Hills discipleship and service program! Please answer each question clearly.
First & Last Name *
Your answer
Age *
Your answer
Date of birth *
Your answer
Applicant's Phone Number *
Your answer
Applicant's Email *
Your answer
Parent/ Guardian Name *
Your answer
Parent/ Guardian's Phone Number *
Your answer
Parents Email *
Your answer
How do you know about Camp of the Hills? *
Your answer
Have you been to Camp of the Hills before? If so, what were you here for? *
Your answer
Why do you want to be a Poiema Camper this Summer? *
Your answer
What do you want to gain from this program? *
Your answer
Available Sessions ( please select the available dates that work best for you) *
Required
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