Youth Camp 2026

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Student Info

Student Name

*

Birthdate

*

Student Shirt Size

*

Please select one option.

XS S M L XL 2XL 3XL

Phone

*

Email

*

This address will receive a confirmation email

Grade Entering

*

Please select all that apply.

7th 8th 9th 10th 11th 12th

Address

*

Student Medication Info

*

Student Allergies

*

Parent Info

Parent Name

*

Parent Phone

*

Parent Email

*

Emergency Contact

*

Emergency Contact Phone

*

Camp Fee Payment

Camp Fee | Full payment due July 5th.

Payment

Camp Fee ($150) Deposit ($50) Applying for Sponsorship ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

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