Camp Mt. Hermon Come Along With Me Camp Registration (Child): May 31 - June 2, 2019
Fill out registration form completely; all fields must be completed. Registration is not complete until clicking the "SUBMIT" button on the last page. Registration confirmation will be sent to the first e-mail address given below.
Email address *
Camper Information
Camper first name *
Your answer
Camper last name *
Your answer
Camper date of birth *
MM
/
DD
/
YYYY
Age during camp *
Your answer
Grade completed *
Gender *
Home phone *
(xxx) xxx-xxxx
Your answer
Cell phone *
(xxx) xxx-xxxx
Your answer
Home address *
Street
Your answer
City, State Zip *
Your answer
E-mail
Your answer
Home church *
Your answer
Parent/Guardian Information
If the information is the same as the camper's, you can write SAME. Don't leave any fields blank.
Father/Guardian's name *
First & Last
Your answer
Father/Guardian's address *
Street
Your answer
Father/Guardian's City, State Zip *
Your answer
Father/Guardian's home phone *
(xxx) xxx-xxxx
Your answer
Father/Guardian's cell phone *
(xxx) xxx-xxxx
Your answer
Father/Guardian's e-mail address *
Home or work
Your answer
Father/Guardian's employer *
Your answer
Father/Guardian's work address *
Street
Your answer
Father/Guardian's work City, State Zip *
Your answer
Father/Guardian's work phone *
(xxx) xxx-xxxx
Your answer
Mother/Guardian's name *
First & Last
Your answer
Mother/Guardian's address *
Street
Your answer
Mother/Guardian's City, State Zip *
Your answer
Mother/Guardian's home phone *
(xxx) xxx-xxxx
Your answer
Mother/Guardian's cell phone *
(xxx) xxx-xxxx
Your answer
Mother/Guardian's e-mail address *
Home or work
Your answer
Mother/Guardian's employer *
Your answer
Mother/Guardian's work address *
Street
Your answer
Mother/Guardian's work City, State Zip *
Your answer
Mother/Guardian's work phone *
(xxx) xxx-xxxx
Your answer
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