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 you plan to attend in the drop down box:

Before selecting, note the camps that are already full - please consider Wilderness Camp during the same week (when available):

Girls:

Boys:

Discovery Camp (full)

Mini Camp 1 (full)

Explorers Camp (full)

Explorers Camp (full)

Solid Rock Camp (full)

 

Discovery Wilderness Camp (full)

 

Cornerstone Camp (full)

Cornerstone Camp (full)

Crossroads Camp (full)

Crossroads Camp (full)

                 

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 the total amount.

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.