RLCC 2021 Registration (August 1st-7th)
RLCC 2021 Registration Form (To be completed NO LATER than July 11th, 2021). "Walk Up" registrations will not be accepted. All campers must be pre-registered.

The all-inclusive cost for RLCC 2021 is $110.00. Subtract $10.00 for each additional attendee). Please mail checks to Newport Ave. Church of Christ, 554 N.W. Newport Ave., Bend, OR. 97701. BE SURE TO WRITE FULL CAMPER NAME IN MEMO LINE. Please be aware that it is the philosophy of RLCC that no child be unable to attend due to financial need. Donors have generously provided sponsorships for those in need of financial assistance. Simply select the options for financial assistance in this form.

***PLEASE READ EACH SECTION CAREFULLY***
Name (Last) *
Name (First) *
Sex *
Age *
Grade Completed *
(As of June 2021)
T-Shirt Size *
(Adult Sizes)
Parent/Guardian Name(s) (STAFF-type in your name) *
Street Address *
City, State, Zip Code *
Emergency Contact *
(Please provide name AND phone number)
Medical Information *
Please provide information on any medical conditions as well as medications and dosage.
Insurance *
Please provide your insurance company, policy number, & name of policy holder for use in the unlikely event of an emergency
Payment (please note the address below as it will not be shown after completing registration) *
Checks: payable to Round Lake Christian Camp. Send checks to 554 NW Newport Ave. Bend, OR 97701. Send PRIOR to the beginning of camp as registration is not complete until payment is received.
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