www.calvincrest.org - Camp, Conference & Retreat Center

*Camper's Last Name:
*Camper's First Name:
Camper's Nickname (if applicable):
*Camper's Gender:
*Camper's Birthdate (including year):
*Camper's Home Phone Number (including area code):
*Grade Camper Completed in May/June:
*Camper's Street Address:
*Camper's City:
*Camper's State:
*Camper's Zip Code:
*Parent's Email:
Camper's Email (optional):
Name of Home Church (optional):
Church City:
Have you ever been to Calvin Crest before?:	YES NO
Have any of your brothers or sisters been to Calvin Crest?:	YES NO
*Parent/Guardian with primary custody:
*Relationship to Camper:
*Best Daytime Phone Number to be reached during week of camp:
*Best evening phone number to be reached during week of camp:
Cell phone number:
Pager Number:
The following person/people are legally restricted from seeing this camper (if applicable) First and Last Name:
Relationship of Legally Restricted Individual to Camper:
Register for a FAMILY CAMP--for youth and adults of all ages. Cost is $155 per room (up to 5 people per room). We will send you additional information after you register. :
Register for EXPLORER CAMP--for campers who have completed grades 1-2 (ages 6-8) with a parent or guardian. Cost is $125 for the first adult and child and $85 for each additional child. :
Register for MIDDLER CAMP-for campers who have completed grades 3-4 (ages 8-10). :
Register for a JUNIOR CAMP-for campers who have completed grades 4-6 (ages 10-12). :
Register for a JUNIOR HIGH CAMP-for campers who have completed grades 6-8 (ages 12-14):
Register for a SENIOR HIGH CAMP-for campers who have completed grades 9-12 (ages 15-18):
Cabin Buddy (limited to two):
*I give Calvin Crest permission to use any photographs/video of my child taken at camp in future promotions of Calvin Crest. I also give permission for Calvin Crest to distribute my camper's name, address and email address (if applicable) to other participants in the event my camper participates in. In signing this form, I hereby certify that the information above is correct and give permission as indicated above and on the health and information form. Please type your name indicating your acceptance of this: