Work Camp Registration Form - Church of the Resurrection

RESURRECTION MIDDLE SCHOOL

Youth Summer Day Service Work Camp 2017 Registration Form

Camper's Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Adult T-Shirt Size*
Present School Attending 2018*
Grade in Fall 2018*
Birthdate*
Month
Day
Year
Mother's Name*
First Last
Father's Name*
First Last
Parent Email*
Parent Cell/Phone*
Payment Amount*
Dates: July 9 - July 13 Cost: $175. Minimum $25 non-refundable deposit required with registration.
Discount Code
Total
$0.00
Credit Card*
Card Details
Cardholder Name
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