Canoe Camp Registration | Cedar Lake Camp

Start Date: Jul 01, 2012

Choose an Option:

Description:

Canoe Camp 2011 will be July 1-7

NOTES:

Canoe Camp is for youth ages 13-18
$150 deposit is due with your registration
This registration serves as consent for the Children's Gospel Hour / Cedar Lake Camp to utilize your or your child's image(s) for the promotion of Cedar Lake Camp. This consent extends to print, digital, and video media.

(the email address listed here will be used for all communication and camp confirmations)

First Name

Last Name

Registrant's street address 1

Registrant's street address 2

Registrant's city

Registrant's state

Registrant's zip code

Registrant's Country

Registrant's Home Phone

Registrant's Mobile Phone

Name of camper's father

Name of camper's mother

Camper's name

Camper's birthdate

Camper's age

Camper's grade completed

Camper's gender

Camper's mailing address (if different than that for Registrant / Financial Contact)

Check if applicable:

If you would like us to send a brochure to a friend, please list names and addresses here:

Home Church

School camper attends

How did you hear about Cedar Lake Camp?

"Other" way you learned about Cedar Lake Camp:

Would you like Cedar Lake Camp to contact you about opportunities to help other children attend camp?