REGISTER FOR CAMP

PLEASE PRINT OUT, SIGN AND BRING WITH YOU TO CAMP BENTLEY for each camp attending and be sure you or your parent or guardian (if a minor) signs the liability form.

» Download Registration Form here

Camp Attending

Name

Phone Cell Phone

Email

Address

City State Zipcode

Home Church

Age Birthdate Grade Entering Gender

Nearest Friend or Relative

Phone Cell Phone

Doctor's Name Phone

Insurance Company

Policy or Group #

Allergies

Medication

Medication Allergies

Shirt Size

Additional Information


Please fill out all fields.