Online Registration

Camp will be held from October 7th - 10th, 2021

1. Contact Information

Name (First and Last)

Phone Number

2. Address

Street

City

State

Zip Code

3. Campers

Please Enter the Number of Adults and Children that will be staying. Children up to 5 years old are free. Adults and children 6 and above are $80.00 ($70.00 if before September 6th, 2021).

Number of Adults ($70.00/per)

Number of Children (Ages 1-5, free)

Number of Children (Ages 6-12, $70.00/per)

Please enter the names of the adults who will be staying, followed by age.

Names (Adults)

4. Emergency Contacts

Contact (Who is also attending camp)

Name of Contact (At Camp)

Phone Number of Contact (At Camp)

Relation of Contact (At Camp)

Contact (Who is not attending camp)

Name of Contact (Offsite)

Phone Number of Contact (Offsite)

Relation of Contact (Offsite)

5. Allergies and Special Considerations

Do you have any known food allergies or other concerns we need to be aware of?

Please note that the camp asks that no personal food be brought to the camp. We will try our best to accommodate any food needs that you notify us of.

6. Arrival Time

On which day and at what time do you expect to arrive?

Please note that each person attending will be required to sign a virus waiver (regarding COVID-19) at check-in (in-person). At this point, masks or face coverings will not be required. It is up to your own personal discretion if you choose to wear masks. If you have questions or concerns, please email charitygracebiblechurch@gmail.com.

7. Payment

Total Amount: $70.00

(Based on the number of campers and their age ranges. Assumes a 4 day stay.)

Payment Options:

In PersonCheck Via MailPayPal

Online Payment via PayPal is selected. Please send $70.00 with PayPal before submitting your application. The link below will open a new tab. Return to this tab to finish submitting your Application when payment is complete.

Go To PayPal