Couples Retreat

"*" indicates required fields

Which Camp are you registering for?*

Adult Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Church Affiliation*

Phone*

Do you have any food allergies?*

yes

If yes please explain:

List Food Allergies

Other Child Registrants

Name

Age

Attending Day 1 ($20.00)

Attending Day 2 ($40.00)

Attending Day 3 ($40.00)

Attendance Fee Total

To add more registrants, click on the (+) button. *Maximum total family fee: $200.00 (Immediate household family members thru age 18)

Other Adult Registrants

Name

Attending Day 1 ($20.00)

Attending Day 2 ($40.00)

Attending Day 3 ($40.00)

Attendance Fee Total

To add more registrants, click on the (+) button. *Maximum total family fee: $200.00 (Immediate household family members thru age 18)

Total Attendance Fee

*Maximum total family fee for Retreat: $200.00 | *Maximum total family fee for Sunday Social: $60.00 (Immediate household family members thru age 18)

Total

Submit

Once you hit submit, your application will automatically be send to camp officials as well as the listed email address above. Payment process requires completing the paypal or credit card information.