Camper Registration

Registration Options

Day Camp ($100.00) [223 remaining]
Kids completing Kindergarten-2nd grade in Spring 2025
Camp Pinerock ($525.00) [102 remaining]
Kids completing 3rd-5th grade in Spring 2025
Ignite Youth Camp ($550.00) [288 remaining]
Students completing 6th-12th grade in Spring 2025

Deposits are refundable if you register before October 15th, 2024.

After October 15th, deposits are non-refundable.

Camper Name

Date of Birth

T-Shirt Size

What is your child's current grade level (2024-2025 school year)

What school does your child currently attend:

Preferred Group Leader:

Name of preferred small group friends:

Which Central location do you attend?

Which weekend experience do you normally attend (time)?

While at camp, is there anyone restricted from seeing your student? If yes, what is their name?

Is your student covered by health insurance?

Does your student have a gluten free diet?

Is your student able to swim unassisted?

Does your student have any food, drug, or environmental allergies?

Does your student have any physical, emotional, mental, or medical conditions? Including ADHD or Autism?

Does your student take any prescription or over the counter medications or treatments?

Parent/Guardian Name

Mobile Phone Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Address

Emergency Contact (other than guardian above)

Emergency Contact Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Relationship to student(s):

Running Total

$0.00

Apply Code

DONATION TO SUMMER CAMP FUNDS

We believe that every kid and student deserves the opportunity to experience the magic of camp and the life-change that God can bring during this time, regardless of financial circumstances. Your generosity can make a difference in the lives of kids and youth who may not have the means to attend. Every little bit helps! Consider making a donation above and beyond your camper's camp costs to help sponsor others and give them the gift of unforgettable memories and life-changing experiences. We sincerely appreciate your support and commitment to making camp a possibility for all kids and students.

Suggested Amounts

$100
$200
$500
Other

Cash or Check Code (to be entered in by Central Staff if you are paying in person with Cash or Check):

CURRENT TOTAL

Total

$0.00

Day Camp (Finishing Kinder - 2nd Grade in Spring 2025)

June 17th - 19th, 2025

Camp Pinerock (Finishing 3rd-5th Grade in Spring 2025)

May 27th - May 31st, 2025

Ignite Youth Camp (Finishing 6th-12th Grade in Spring 2025)

June 12th - June 16th, 2025

Register Today!

CAMPER REGISTRATION

Camper Registration

PARENT / GUARDIAN INFORMATION

DONATION TO SUMMER CAMP FUNDS

CURRENT TOTAL

BILLING INFORMATION