Kaleidoscope Camp Registration
           
Name:
Street Address:
City: State: Zip:
Phone: () Email:
Age: Date of Birth (mm/dd/yyyy): Sex: M F
Rising Grade: School:
Church:
Pastor:
T-Shirt Size:
Cabin Partner Request: This person should also request you.
 
Parent/Guardian 1 First Name: Last Name:
Home Phone: ()
Work Phone: ()
Cell Phone: ()
 
Parent/Guardian 2 First Name: Last Name:
Home Phone: ()
Work Phone: ()
Cell Phone: ()
 

         Select the Camp Below

Mini Camp 1 Ages: 7-9
July 1-3
$210
Mini Camp 2 Ages: 8-10
June 24-27
$240
Discovery Camp Ages: 9-11
July 29-Aug. 2
$325
Crossroads Camp Ages: 14-16
July 8-12
$325
Solid Rock Camp Ages: 12-14
July 15-19
$325
Cornerstone Camp Ages: 11-13
July 22-26
$325
Winter Youth Retreat December 28-30
 
$125 ($105 if received by 11/1/11)
Deduct $10 from tuition cost if you register by March 1.

*For Crossroads and Solid Rock Camps Only*
For Crossroads Campers: Please enter 4 first choice time slots as well as 4 second choice time slots.
For Solid Rock Campers: Please enter 2 first choice time slots as well as 2 second choice time slots.

  • Archery/Slingshot
  • Backpacking
  • Broom Hockey
  • Canoeing
  • Cooking
  • Crochet
  • Dance
  • Digital Photography
  • Duct Tape Art
  • Face Painting
  • Frisbee Golf
  • Geo-caching
  • Jewelry Making
  • Knitting
  • Nature
  • Percussion
  • Pottery(flat)
  • High Ropes (Crossroads)
    Solid Rock it's part of the activity rotation
  • Sewing (drawstring backpack)
  • Tie Dyeing
Time slot 1st choices:
Time slot 2nd choices:
Before pressing submit, to prevent spam please enter the code from the image above exactly as it appears.
 

To complete registration you may pay the $50 non refundable deposit or you may pay in full.

You will be able to choose on the next page

Payments (check and credit cards including VISA, Master Card, Discover & American Express) are accepted on the secure PayPal site, even if you do not have a PayPal account. Click Submit below to confirm your information and be redirected to the PayPal site for payment.