Summer Registration

Online registrations must be paid online. When you submit this form you will be directed to Paypal to complete your payment. Registrations will not be processed unless payment is received. Only a $45 non-refundable deposit must be paid at this time, though you have the option of paying the entire amount. A $1 online processing fee applies to deposits and a $5 fee for the entire amount.

Fees are as follows:
-Day camp - $115 ($120 with online payment fee)
-Overnight Camp -$210 ($215 with online payment fee)
-Mini Camp- $105 ($110 with online payment fee)
*Camp fees include lodging, meals, a craft, activities, a Keepsake DVD, and a T-Shirt. Optional activities may be offered for an extra fee.

Space is limited. reservations will be made on a first come, first served basis. Registration is complete when both your form and deposit are received. You will receive a confirmation packet in the mail.


	2012 Summer Camp Registration


	Camper’s Name:


	Birth Date:


	Gender:


	Age (at camp):


	Goes by:


	Grade (2012-2013):


	Mailing Address:


	City:


	State:


	Zip Code:


	Legal Guardian #1:


	Relationship:


	Contact #:


	or


	Legal Guardian #2:


	Relationship:


	Contact #:


	or


	Emergency contact other than parents and relationship:


	Emergency contact’s phone number:


	Did you do Mailbox Club lessons this year?


	Did you do Correspondence lessons this year?


	Do you attend church?


	Name of Church:


	E-Mail Address:


	Cabin Mate Request:


	You may only request one friend. Your friend must also request you. Please mark the week you plan to attend. Grades are based on the grade student is entering in the fall

June 10-15	Grades 9-12
June 17-22	Grades 4-6
June 24-29	Grades 5-8
July 2-6	Day camp for Grades 1-3*
July 8-13	Grades 5-8
July 15-20	Grades 3-5
July 22-24	Mini camp for Grades 2-5*


	Select Camp Week Here:


	*Correspondence lessons & Mailbox club scholarships apply only to regular weeks of overnight camp.


	T.E.A.M.


	Please mark here if you wish to be scheduled for a week of service as a TEAM member. Grades 9-12 only. TEAM members are expected to attend Teen Camp*


	Choose your T-Shirt size. Every camper receives a camp shirt.


	Transportation:


	Day Campers Only! Mark here if you would like help with transportation. There is an extra fee of $20 per child. If there are less than 20 riders the fee will be $25. -you will receive more info in your confirmation packet.


	Please mark a morning & afternoon bus stop

		AM Stop


	PM Stop

By clicking submit I agree to the following:
-I agree to have my child’s immunizations current and a notarized medical form completed before entering camp.
-I give my child permission to participate in the entire camp program unless otherwise listed on the medical form.
-I give permission for my child to be photographed/videotaped for the purpose of promoting Camp Grace.
-I understand that if my child misbehaves or brings unacceptable items he/she will be sent home without a refund.
-I agree that my child will NOT bring a cell phone and will abide by the dress code that will be sent with the confirmation packet.


	Summer Registration