2018 Registration Form
Nebraska Youth Camp
Camper First Name *
Your answer
Camper Last Name *
Your answer
Parent/Guardian *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
Primary Phone *
Just the numbers, no dividers please.
Your answer
Other Phone
Just the numbers, no dividers please.
Your answer
Home Congregation
Your answer
Email Address *
Acceptance notice and further camp information will be sent via e-mail.
Your answer
Camper Birth Date *
MM
/
DD
/
YYYY
Age *
Your answer
2017-2018 Grade *
Camper Gender *
Shirt Size *
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