2019 Day Camp Registration

July 8-12, 2019 | Please complete the registration form for 2019 Hill Avenue Lutheran Day Camp. We are looking forward to a week full of faith, fun, and friends! Additional registration forms will be emailed separately.

Name

*

Year in School

*

Please select one option.

Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade

Parent Name

*

Email

*

This address will receive a confirmation email

Phone

*

Emergency Contact

*

Address

*

Media & photo release

*

Please select all that apply.

Yes No

Health Concerns/Allergies

*

Payment

registration ($75.00) Sponsor another camper ($150.00) Financial Scholarship Camper ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 8-12, 2019

Please complete the registration form for 2019 Hill Avenue Lutheran Day Camp. We are looking forward to a week full of faith, fun, and friends! Additional registration forms will be emailed separately.

Please Fix the Following

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