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Kicklighter Christian Camp
Camper Application
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Camper Name (First and Last)
*
Your answer
Which camp will you be attending as a Camper.
*
Choose
CYF (going into 9th, 10th, 11th, 12th or 2023 High School Graduate) - June 4 - 9, 2023
Chi-Rho (going into 6th, 7th or 8th) - June 11 - 16, 2023
Junior (going into 3rd, 4th or 5th) - June 18 - 23, 2023
Home Address - Street Address and City, State Zip
*
Your answer
Home Phone Number
Your answer
Sponsoring Church
*
If you are not from one of the churches listed below please choose "Other" and list how you heard about Camp Kicklighter.
Antioch Christian Church (Sylvania, GA)
Glennville Christian Church (Glennville, GA)
Guyton Christian Church (Guyton, GA)
Chapel Christian Church (Winder, GA)
Pembroke Christian Church (Pembroke, GA)
Savannah Christian Church (Savannah, GA)
Other:
Church you Attend
*
If you do not attend one of the churches listed below please choose "Other" and list the church you attend.
Antioch Christian Church (Sylvania, GA)
Glennville Christian Church (Glennville, GA)
Guyton Christian Church (Guyton, GA)
Chapel Christian Church (Winder, GA)
Pembroke Christian Church (Pembroke, GA)
Savannah Christian Church (Savannah, GA)
Other:
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
Sex
*
Choose
Male
Female
Grade you will have completed in School
Your answer
Number of years you have attended Camp Kicklighter
Your answer
T-Shirt Sizes
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Choose
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Camper E-mail Address
Your answer
Camper Cell Phone Number
Your answer
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