2008 Camper Application

Please enter payment amount in the space provided below. Minimum Deposit is $30.00. Cost in Full is $150.00. Form will NOT be processed unless a minimum deposit is made via PayPal. You will receive a confirmation email once form/payment is processed. Thank you.
Payment Amount	*
Last Name	*
First Name	*
Age	*
Address	*
City	*
State	*
Zip Code	*
Phone	*
Email Address	*
Gender	*	Male Female
Date of Birth	*
Name/Location of Congregation Attending	*
Parent/Guardian	*
Parent/Guardian Phone	*
Emergency Contact	*
Emergency Contact Phone	*
Camp Session	*	Junior Week - July 13-19 : Grade Completed 2 to 5 Senior Week - July 20-26 : Grade Completed 9 to 12 Intermediate Week - July 27 - August 2 : Grade Completed 6 to 8
Cabin Partner Preference (if any)
Select T-Shirt Size Desired	*	Small Medium Large XL 2X 3X
Security Code	*