Virginia Youth Camp - 2024 - Pre-Teen Registration

Youth Camp (Ages 7-12): June 22-29

Please enter the Parent / Guardian Email below

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Email *
Parent / Guardian Name *
Parent / Guardian Phone *
Emergency Contact Phone *
Camper's First Name *
Camper's Last Name *
Camper's Email (if they have one)
Date of Birth *
Address *
Sunday School Attended *
Health Insurance Provider
Health Insurance Policy Number
Medications, Allergies, or Special Needs
Permission to Treat *
Tuition is $50 per camper (there is a $120 max per family per year). Please make checks payable to Christadelphian Youth Camp and bring on the first day of camp.
A copy of your responses will be emailed to the address you provided.
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