Register

 Required fields
Details
Title:
If "Other" please enter here
Gender:
First Name: (as you would like on your name tag)
Surname:
Address
Street:
Suburb:
City:
Country:
Post Code:
Home phone:
Work phone:
Cellphone:
Email:  
Church:
If your church name is not in the list enter it in the box:
Age at 1 January 2012:
School Year (in 2012):
Programme:
Price and Accommodation:
 DescriptionAfter 1/12/10
Youth (13-15 years) - Tent$95.00
Children (4-12 years) - Tent$85.00
Pre School (0-3 years) - Elm Court$0.00
Pre School (0-3 years) - Tent$0.00
Children (4-12 years)- Elm Court$145.00
Adults (16 years +) - Offsite$125.00
Youth (13-15 years) - Bunk$105.00
Pre School (0-3 years) - Bunk$0.00
Adults (16 years +) - Tent$145.00
Children (4-12 years) - Bunk$95.00
Adults (16 years +) - Bunk$165.00
Youth (13-15 years) - Elm Court$165.00
Adults (16 years +) - Elm Court$225.00
Children (4-12 years) - Offsite$75.00
Youth (13-15 years) - Offsite$75.00
Pre School (0-3 years) - Offsite$0.00
Grace Box: Sponsorship to help others get to camp: $
Request for sponsorship assistance: $
Additional Information
Role in Church Leadership (if relevant):
Other Leadership:
Medical concerns we should know:
Notes (requests, information, casual registrations, groups):
Willing to help: