2019 LGP (Lutheran Girl Pioneer) District Camp Registration Form
Welcome to the 2019 LGP District Camp Registration Form. We are so excited you have decided to join us for camp this year. Please fill out all of the answers on this form and click submit at the end. PLEASE NOTE. Your form will not be processed, nor will a cabin spot be held for you until we receive payment along with the completed Permission/Medical Form. You can find that document here


Both adults and children needs completed Permission/Medical Forms.

If you have any questions, please our Camp Director

Lori Holicky
Phone: 952-758-5125 (Home)
952-769-3163 (Cell)
Email: holicky@bevcomm.net

***ON-LINE REGISTRATION WILL CLOSE ON MAY 24. If you wish to register after that date, you need to contact Lori Holicky to see if there are still openings. All late registrations will be assessed a $10/camper fee***

Email address *
2019 LGP District Camp Information
Camp Dates: June 13 -15 (registration begins at 6pm, please eat supper before your arrival and girls must be picked up by 3:00pm on the 15th).
Location: LGP District Camp is held at the group camp center in Flandrau State Park, in New Ulm, MN. Detailed directions to the camp site will be sent to each camper once all forms and payment are received.

Theme: It is all about Love!
Bible passage: Jesus replied: "Love the Lord your God with all your heart and with all your soul and with all your mind. This is the first and the greatest commandment and the second is like it "Love your neighbor as yourself". Matthew 22:37-39

First Child - $35.00
Additional Child - $20.00
Moms/Adult Leaders - $20.00
*Late fee of $10/camper will be assessed for registrations received after May 24, 2019*
*Please make checks payable to Lutheran Girl Pioneers*

Mail checks to:
Lori Holicky
30473 181st Avenue
New Prague, MN 56071

Camper & Parent Contact Information
Each child and each adult camper needs to fill out a separate form.
Camper First Name *
Your answer
Camper Last Name *
Your answer
Birthdate *
Age *
Your answer
Grade (for the upcoming school year) If an adult, simply indicate N/A *
Your answer
Select One *
Street Address *
Your answer
State *
Zip Code *
Your answer
Parent Name(s) If an adult, simply indicate N/A *
Your answer
Home/Cell Phone #1 *
Your answer
Cell Phone #2 (optional)
Your answer
Parent Email #1 if different from what you entered above.
Your answer
Parent Email #2 (optional)
Your answer
Emergency Contact - Name *
Your answer
Emergency Contact - Relation *
Your answer
Emergency Contact - Phone *
Your answer
Church Name *
Your answer
Church Town *
Your answer
Would you like to be a Junior Leader? (must be going into grades 9-12) *
Is this your first year at camp *
How many years have you attended camp? *
Your answer
Preferred Cabin Mate #1 (leave blank if you have no preferences) We will do our best to accommodate requests.
Your answer
If you are an adult camper, can you help with transportation? If yes, how many can you transport in addition to yourself?
Your answer
Each cabin has one adult leader as the “Cabin Mom.” She is the one responsible to see that the girls are where they are supposed to be and help with devotions and other activities. If you are an adult camper, are you interested in being a cabin mom? (you will be contacted in early June if you have been assigned to this role)
If you are an adult camper, would you like to room with your daughter? If so, please provide your daughters name. (all Sunbeam campers will be placed with their adult companion)
Your answer
Flandrau is a State Park so it does require a Daily Park pass at $7.00 per day or Annual Pass for $35.00 for each vehicle entering the park. Passes can be picked up & paid for at the main entrance to the park. I have read this an understand that I must have a pass to bring a vehicle into Flandrau. *
I understand that I need to mail a current photo of each child camper along with payment to Lori Holicky 30473 181st Avenue, New Prague, MN 56071 *
I understand that each camper (adult and child) must have a completed Permission/Medical form. A link to the form is provided at the top of this registration form. This form can also be mailed to Lori Holicky 30473 181st Avenue, New Prague, MN 56071 *
I understand that if my registration materials are not received by May 24, 2019 that I will be assessed a $10/camper fee if there is still space available. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Gustavus Adolphus College. Report Abuse - Terms of Service