ONLINE REGISTRATION

for July 19-25, 2009 Summer Camp session

First Name:

Last Name:

Address:    

City:            

State:         

Zip Code:  

Birthdate (month/date/year):  

Home Phone:

Work/Cell Phone:

Parents/Guardians names:

Camper Email Address:

Parent Email Address:

Have you attended Higher Ground before: Yes No

If yes, what years:

Male or Female: Male Female

Tshirt Size: Child Small Child Medium Child Large Small (34-36) Medium (38-40) Large (42-44) X-Large (46-48) XX-Large (over 48) 3XL

Why would you like to be a camper at Higher Ground?

 What are some of your hobbies/interest?

Where did you hear about Higher Ground (mark all that apply by holding down the Control CTRL button on your keyboard): Internet Search Brochure Camp Video Friend Church

If you heard of camp from a friend or church please give us their name:

Roommate requests (must be similar age):

Does the applicant have a condition that limits or prohibits physical activity?

Yes No

If yes, what are those limitations:

For parents/guardians of minor applicants (those 17 years of age and younger): I hereby give Higher Ground permission to participate in all activities at Higher Ground, unless specifically limited above. I give permission for my child to be transported off the camp property to camp-related activities.

For the applicant: Higher Ground may use any photos and videotapes taken of the applicant at any camp event in their publications of those of the Generations Camp Ministry.

Parent/Guardian Signature:

Camper Signature:

Application Process: Registrations will be reviewed as they are received and you will  receive an email confirming receipt of the online registration within a day or two. Upon receipt of your non-refundable $50 deposit an accept packet and tuition statement will be mailed to the camper. The $50 deposit will reserve a space.