Registration Form

Contact Information

Name *

First

Last

Email *

Gender *

Age *

Age at time of camp

Baptized Member of Amended Fellowship *

Ecclesia

Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Shirt Size *

Sizes for crazy Olympics shirt

Willing to be in photos shown online to promote the camp?

Health Info

Food Restrictions

Date of Birth

Health Care Number

Private

Emergency Contact *

First

Last

Emergency Contact's Phone

Emergency Contact's Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Doctor

First

Last

Doctor's Phone

Doctor's Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Medical form *

Click or drag a file to this area to upload.

Please have your legal parent or guardian fill out the form and attach it here

Download Form

Camp Help

Please select below areas you might be interested in helping out at camp

Help with:

Checkboxes

Presider
Devotional Leader
Prayers

For Lifeguards

Please list your qualifications

For Nurses

Please list your qualifications

CPR

Please list your qualifications