Kids Rock Family Camp Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Primary Contact *FirstLastPrimary Contact Email *Primary Contact Phone *How Many Campers *— Select Choice —123456Camper 1 Name *FirstLastCamper 1 Adult/YouthAdultYouthCamper 3 Name FirstLastCamper 2 Adult/YouthAdultYouthCamper 4 NameFirstLastCamper 3 Adult/YouthAdultYouthCamper 5 NameFirstLastCamper 4 Adult/YouthAdultYouthCamper 6 NameFirstLastCamper 5 Adult/YouthAdultYouthCamper 6 Adult/YouthAdultYouthCamper 2 NameFirstLastAdditional Campers – Please list First Name, Last Name, and Adult or Youth Wall Tent One of our 14×16′ Wall Tents used for Accommodations during Camp CheckboxesPlease set up a wall tent for me.Permission & Agreement For Campers To Participate In The Following Skills Development *I agree and give my permissionArchery and Slingshot: Supervised and fun! Air Rifles: Safety instruction and marksmanship training. Hiking: Enjoying the beauty and nature of the local terrain. Swimming: With-in the roped-off area. Participants (or parents of those under 18) will need to sign a waiver at camp.Select Registration Type *— People Being Registered —1 – 2 People – $75.003 Or More People – $100.00Payment MethodCredit CardeTransferCredit Card *eTransferI will be sending payment through eTransfer1-2 People = $75.00 3 Or More People = $100.00 Send eTransfers to: bethelchurchclinton@gmail.comTotal$0.00 Adult/Youth Contact Email Additional InformationSubmit
