SCUBA - Dive Deep into Friendship with God

Registration is on a first come first serve basis and will be taken down when it is full. *

Your child may only register for one week. No Execeptions.

WEEK 1 - July 22 - July 26 (Waitlist Only - Do not pay until we have confirmed your spot)

WEEK 2 - August 5 - August 9

Name of Guardian 1 *

First Name

Last Name

Name of Guardian 2

First Name

Last Name

Phone Number of Guardian 1 *

(###)

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Phone Number of Guardian 2

(###)

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number *

(###)

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Name of Camper *

First Name

Last Name

Camper's Birthday *

MM

DD

YYYY

Name of Camper 2 (if applicable)

For families registering siblings.

First Name

Last Name

Camper 2's Birthday

MM

DD

YYYY

I allow photos & videos taken of my child to be used for church purposes *

Yes

No

I have read and accept the illness disclaimer mentioned on the information page: *

Yes

No

Payment *

I agree to pay $120 per child to secure my registration. I understand I will be charged a $20 per child cancellation fee.

I am requesting contact for fee assistance.