EMBC 2019 Online Registration Form
Registration for EMBC summer youth camps. Please print the health release form and bring with you to registration.
Last Name *
Your answer
First Name *
Your answer
Male/Female *
Required
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parents Name
Your answer
Parent's Address, if different than above
Your answer
Home Phone *
Your answer
Work Phone
Your answer
Name of Church or Pastor
Your answer
Cabin Roommate request ( limit 2)
Your answer
Registration fees for camper *
Offering
Optional
Your answer
Snacks
recommend $10-20
Your answer
Possible Discounts
Total Due *
This amount can be paid online by following the link on the previous page or the amount can be mailed to: 1862 Rd 523 Bloomfield, MT 59315
Your answer
Camp Gear
*NEW THIS YEAR -Each camper will receive a t-shirt at registration as part of the camp fees. Other camp gear: hats, shorts, sweatshirts, water bottles, notebooks and flashlights will be available for purchase at camp.
please select your camper's t-shirt size *
Information to make the week of camp go smoother
**If your child has special dietary needs please contact EMBC (406-583-7573) prior to the week of camp to make arrangements. EMBC attempts to accommodate dietary needs, but sometimes supplemental food provided by the family may be needed.

**If your child needs to take medication during the week of camp, please send the medication in the container from the Pharmacy with the pharmacy labels attached.
Eastern Montana Bible Camp Terms and Conditions
I understand by filling out the online registration form and agreeing to EMBC’s terms and conditions, I give my camper permission to use the Jungle swing, zipline, pool, climbing wall, and archery equipment. I understand these activities will be used only with staff supervision. I allow my camper’s picture or comments to be used in promotional materials for Eastern Montana Bible Camp. I give my permission for emergency medical attention for my registered camper and I allow them to have over the counter medications such as Tylenol or tums. I understand if I do not agree to any of these terms or conditions, I must let EMBC know in writing at registration, prior to the week of camp.
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Terms and Conditions *
I agree to EMBC's terms and conditions
Required
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