CPL Camper Registration Form
All information submitted is vital to the provision of our ministry to the campers that attend Camp Pine Lake. We also recognize the importance of much of this information to each of you and take great care to protect the integrity and confidentiality of all collected information.
Middle Name
Your answer
Last Name
Your answer
First Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Camper's Email
Your answer
Would you like to receive the CPL e-newsletter at this camper's email?
Camper's Phone Number
Your answer
Home Church
Your answer
Sponsoring Church (if different from Home Church)
Your answer
If attending Primary Overnight, Adult Camper Name
Your answer
Gender
Birthdate
MM
/
DD
/
YYYY
Grade Completed
Camp Attending
Cabin Mate Choice
Name one person only. Your cabin mate choice will be honored (if at all possible) ONLY if you both request each other.
Your answer
First Time Camper
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