LAKESIDE FOR YOUTH 2021 REGISTRATION
Email *
Camp Cost
Week of Camp *
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Phone Number *
Church Name (Please select the church you are coming with) *
STATUS SELECTION INFORMATION
Please be careful and select the correct "Status" below according to the following explanations.
Senior High Youth (incoming freshman to '21 graduate)
C1 (Second and Third summers after high school or equivalent)
C2 (Fourth Summer after high school or equivalent until age 23)
Junior High Youth (completed 5th through completed 7th grade)
Senior Counselor (24+)
House Parent (Person staying with the group but NOT eating meals in Wesley and NOT attending sessions in South)
Child of Counselor (Child not of age to attend as a youth but is staying with the group and NOT eating meals in Wesley)
Status *
Date of Birth *
MM
/
DD
/
YYYY
Grade Completed (Summer 2021) *
Shirt Size *
Vegetarian *
NOTICE
I AGREE (TYPE NAME) *
Today's Date *
MM
/
DD
/
YYYY
Comments/Notes
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy