CSB Summer Camp Registration Form

 

Camper Information
First Name:
Last Name:
Birthday:	mm/dd/yyyy
Address:
City:
State:
Zip Code:
Camper's Email	optional
Home Church:
Parent(s)/Guardian(s)
Parent Name:	Mother Father Grandparent Guardian
Parent Name:	Mother Father Grandparent Guardian
Home Phone:
Cell Phone:
Parent Email:
Cabin Mate Requests
Name:
Name:
Name:
Name:
Special Requests