Children of Promise: Online Registration

Forms for Download

You may register online by completing the form below; to register by mail, please download the PDF Registration Form:
Download Registration Form [PDF, 100kb]

*Please complete all required fields below:

Step 1 of 2: Submit Registration (One form per camper, please)

Registration Info:
(A confirmation e-mail will be sent to the address you provide below)

Your Name:
Your E-mail:

Camper Info:

Sex:
First Name:
Last Name:
Camper's Phone:
Date of Birth:
Age at Camp:

Camper's Address:

Street / Apt:

City:
State:
ZIP:

Parent(s) / Guardian Info:

Father / Guardian:
Home Phone:
Work Phone:
Cell Phone:
E-mail:

Mother / Guardian:
Home Phone:
Work Phone
Cell Phone:
E-mail:

Preferred Sessions:

Session 1: May 27-May 30	Session 7: July 7-July 11
Session 2: June 2-June 6	Session 8: July 14-July 18
Session 3: June 9-June 13	Session 9: July 21-July 25
Session 4: June 16-June 20	Session 10: July 28-Aug. 1
Session 5: June 23-June 27	Session 11: Aug. 4-Aug. 8
Session 6: June 30-July 3

Registration Fee(s):

Single Camper, $75

Family Registration, $125

I have already paid the registration fee(s).

Total:

(NOTE: You do not have to pay the entire total all at once;
you will be able to pay week to week!)