Student Ministry Weekend Camp 2026

Student Name

Grade completed in May

5th 6th 7th 8th 9th 10th 11th 12th

Family Email

This address will receive a confirmation email

Parent/ Guardian Name

Parent/ Guardian Phone Number

Other Parent or Emergency Contact Name

Other Contact Phone Number

Are there any food allergies or dietary restrictions?

Will this student require daily medication on this trip?

yes no

Does the student have any allergies, chronic illness, or medical conditions that the adults on the trip should know about?

Please use this section for the second student if you are registering more than one.

Student Name

Grade completed as of May 5th 6th 7th 8th 9th 10th 11th 12th

Are there any food allergies or dietary restrictions?

Student: Will they require daily medication on the trip? yes no

Does the student have any allergies, chronic illness, or medical conditions that the adults should know about?

Triip Registration Cost:

The total cost of camp is $80 per student for the weekend. A $20 deposit is required to hold a spot. The total balance is due June 1st. A $30 camp discount will be given to students who helped with a recent fundraiser. The entire balance can be paid now, or the remaining balance can be paid later by cash or check. Four scholarships are available and require completion of a scholarship form and approval of the scholarship application. Please email, call, or text Haley if you have any questions.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Student Ministry Weekend Camp 2026

Description

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