TEEN CAMP ONLY AGES 13-18

Registration Options

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Camp T-Shirt

T-Shirt

T-Shirt
$20.00 ea.
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T-Shirt Size

Camper Name

Date of Birth

Are you over 18.

Address

Gender

Male
Female

Church

Camper Signature

I, the undersigned, agree to the terms above.

A signed waiver by event participant or parent/guardian will be required before you can download your QR code. A link to obtain waivers for all registrants will be shown on the confirmation page.

Insurance Company Name

Insurance ID Number

Primary Physician

Physician Phone Number

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

I grant permission to the Pentecostal Church of God Southern California District Inc, to use my image (photographs and video) for use in Media publications including but not limited to:

Videos
Email Blasts
Recruiting Brochures
Newsletters
Magazines
General Publications
Website and/or Affiliates
Other

Please select from the following choices:

I am the parent/legal guardian of the child attending camp.
I am a camper who is 18 years of age or older.

Camper Medical Release Form

Medical Release Form Options

CLICK HERE TO DOWNLOAD THE MEDICAL RELEASE FORM

Running Total

$0.00

Convenience Fee

$0.00

Special Code

Total

$0.00

Event Registration Software by RegFox

TEEN CAMP ONLY AGES 13-18

Registration Options

Camp T-Shirt

T-Shirt

INSURANCE INFORMATION

EMERGENCY CONTACT INFORMATION

Camper Medical Release Form

PAYMENT

**TEEN CAMP ONLY AGES 13-18**

Registration Options

Camp T-Shirt

T-Shirt

INSURANCE INFORMATION

EMERGENCY CONTACT INFORMATION

Camper Medical Release Form

PAYMENT

TEEN CAMP ONLY AGES 13-18