Application for Jr. High Camp
Complete this form for your students. Please note that payments must be received at least one week prior to camp. Be sure to note on the check who is being covered so we can properly credit payments for participants. Make checks payable to AGQBA.

Each school must provide 1 Coach or adult per 6 students.

Mail payments to:
Pam Braun
Norfork High School
136 Mildred Simpson Dr
Norfork, AR 72658

For further questions, please email Pam Braun at pam.braun@norfork.k12.ar.us.
Email address *
Camp you are attending *
Coach's Name *
Your answer
School *
Your answer
Coach's Cell Number *
Your answer
Number of Coaches attending?* *
One (1) coach or adult is required per every six (6) students. Coaches are free to attend unless they would like a t-shirt. T-shirts are $15 per shirt.
Coaches'/Adults' Names *
Please list all adults attending.
Your answer
Number of T-shirts Needed for Adults *
Adults' T-shirt Sizes *
Your answer
Total Due for Adult T-shirts *
$15 per shirt
Your answer
Students Attending
The fee per student is $20. This fee includes a t-shirt, supplies, and snacks. All participant fees must be paid at least one week prior to camp.
Name of Student 1 *
Your answer
Grade of Student 1 *
Student 1's Shirt Size *
Name of Student 2 *
Your answer
Grade of Student 2 *
Student 2's Shirt Size *
Name of Student 3 *
Your answer
Grade of Student 3 *
Student 3's Shirt Size *
Name of Student 4 *
Your answer
Grade of Student 4 *
Student 4's Shirt Size *
Name of Student 5 *
Your answer
Grade of Student 5 *
Student 5's Shirt Size *
Name of Student 6
Your answer
Grade of Student 6
Student 6's Shirt Size
Name of Student 7
Your answer
Grade of Student 7
Student 7's Shirt Size
Name of Student 8
Your answer
Grade of Student 8
Student 8's Shirt Size
Name of Student 9
Your answer
Grade of Student 9
Student 9's Shirt Size
Name of Student 10
Your answer
Grade of Student 10
Student 10's Shirt Size
Name of Student 11
Your answer
Grade of Student 11
Student 11's Shirt Size
Name of Student 12
Your answer
Grade of Student 12
Student 12's Shirt Size
A copy of your responses will be emailed to the address you provided.
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