| Which session do you wish to attend? |
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Camper Name
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Mailing Address
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City
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State
Zip
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| E-Mail Address |
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| D.O.B.(MMDDYY) |
Grade
Sex
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Home Phone
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Father's Name
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Father's Work Phone
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cell
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Mother's Name
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Mother's Work Phone
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cell
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Church You Attend
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Roommate Preference
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Payment Information:
- Deposit for individual camper is $100 (non-refundable)
- Individual campers (campers not with a church group) pay and extra $50 counsellor fee.
- Please make all checks payable to
Sugar Pine Christian Camps
.
- If you wish to pay by credit card, please call Deb at 559 683-4938 X 101 and she will be happy to take your information.
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NAME OF ADULTS AUTHORIZED TO PICK UP YOUR CHILD:
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Sugar Pine Christian Camps will release your child only to adults listed below.
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Emergency Information
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If you child should require medical attention at camp for injuries or illness contracted prior to coming to camp, the following information will be necessary to give your child proper medical service.
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| Do you have insurance? |
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| Insurance Company |
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| Policy Number |
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| Name of Insured |
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| Family Doctor |
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