Middle + High School Summer Camp

Student's Information

Camp is scheduled July 6th - July 9th and is open for middle and high school students.
Name
Address
Birthdate

Parent/Guardian Information

Parent/Guardian
Relationship to Student
Phone
Email
Parent/Guardian
Relationship to Student
Phone
Email

Permission

I, the above mentioned parent/guardian, give my permission for the student listed above to participate in the overall activities of the Revive Summer Camp. I give my permission for my student to receive medical attention in the case of an emergency. I/We agree not to hold Bethel Church, its leaders, employees, agents or volunteer staff liable for damages, losses, diseases or injuries incurred during the events by the student listed on this form.
Parent Signature


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Payment

Cost is $110 per person. A $25 deposit is due by June 20th. Students registering for camp after June 21st will incur a $15 late fee.
Payment Method

Register