Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Parent/Guardian's Phone Number *

(###)

###

####

Is there a church you attend regularly? *

Yes

No

I don't know

What areas of service would you be interested in helping with this summer? *

Check any and all that apply.

Cabin Leading

Activity/Games

Chapel/Campfires

Maintenance

Kitchen

Reference #1 *

First Name

Last Name

Reference #1 Phone number *

(###)

###

####

Reference #2 *

First Name

Last Name

Reference #2 Phone Number *

(###)

###

####

Are you also interested in volunteering for Family Camp? *

Yes

No

Maybe, I'll think about it