2017 Woodland Bible Camp Registration Form

 

Please complete this registration form, and then continue to the Camp Store to select 1 or more camp weeks. You will have the option to mail your payment or pay online with a credit card (Visa, MasterCard, American Express, Discover) via a secure PayPal connection. A processing fee of 2.2% + $0.30 is applied to online payments. Please note this amount will be taken from the total camp fee, and will not be added to your total bill.    

Please select the Camp Event for which you wish to register:

Basic Information
Camper Name
*
Street Address
*
City
*
State
*
Zip Code
*
Email Address
*
Home Phone Number
*
Mobile Phone Number
Emergency Phone Numbers
*
Home Church
Grade Entering This Fall

Camper Health Information
Camper Age
Insurance Company
Insurance ID Number
Family Doctor Name
Family Doctor Phone Number
Medical Problems
Name of Medications (Please list name and dosing interval of medication and the condition for which it is taken.)
Medication Allergies (Please list)
Other Allergies (Please list)

Select your shirt size:
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL

Other comments (i.e. requests to be in a cabin together, special needs, etc.):

 

End of Form