2017 Agapé Family Camp Registration
Please fully complete registration form. If you have any questions, please call our Camp Agapé office at 919-552-9421.

If you are having trouble moving between fields on the form, use the "tab" key to navigate to the next section.

Name of family contact *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
Address *
Your answer
City, State *
Your answer
Zip Code *
Your answer
Home Church
Your answer
Other Participants' names listed: *
Please put children's ages after names or designate as adult
Your answer
Number of family members attending: *
Your answer
Where would you like to stay during your Family Camp? *
Would you like linens provided? (additional $8.50 per person) *
Special needs or Dietary Concerns:
Your answer
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