Request a Weekend
Please complete the below form in its entirety. Requests are not final until you receive a confirmation e-mail from us. We reserve the right to deny your request at any time without having to provide a reason.
Primary Contact Name *
Your answer
Primary Contact Phone Number *
Your answer
Primary Contact E-mail *
Your answer
Group Name *
e.g. First Church of God Youth Group, Cub Scout Pack 123, etc.
Your answer
Charter Organization and Location
e.g. First Church of God, Acmeville, PA
Your answer
Requested Dates *
e.g. 6/1/11 - 6/3/11
Your answer
Total Number of Campers *
Requested Facilities
Please select the facilities/activities you wish to use. This is not an all-inclusive list; only those items that require preparation by the Campmaster are listed.
Would you like to complete a Service Project? *
Use the "Other" choice if you have a special project request.
Please enter any special requests, comments or otherwise below.
Your answer
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