Personal Information
This registration is ONLY for staff / counselor.

Registration for camp closes completely on June 2, 2023.
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Email *
First Name *
Last Name *
Gender *
Phone Number *
Mailing Address (Street) *
City *
State *
Current Occupation *
Relationship Status *
Age on June 11, 2023 *
Birthday *
Have you ever been arrested and / or convicted of a crime involving drugs, sex, or violence? *
If yes, please explain:
What church do you attend? *
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