LMYC Registration 2017

Lower Michigan Youth Camp Registration

IMPORTANT INFORMATION – PLEASE READ!

  • If you have not yet read the camp information page, you should do so before filling out this registration form.
  • The camp will begin at 3:00 pm EDT on Monday, August 7, 2017 and will close at approximately 11:00 am on Thursday, August 10, 2017.
  • There is space at the park for 30 student campers. Registration is open to students entering 6th through 12th grades and is on a “first come, first served” basis.
  • After you submit this form, please mail a check for $50 per student payable to: Rev. David Schaller. Send to: Redeemer Lutheran Church, 66325 M 152, Dowagiac, MI 49047. Write “Youth Camp” on the memo line of your check as well as the student(s) name(s). Completed registrations are due by Sunday, July 30, 2017.
  • Along with your camp payment, you must also send a completed¬†medical authorization and release form for each student.

REGISTRATION FORM

Please submit a registration form for each student attending. Fields highlighted in red are required.

  Student Name 
Street Address 
          City  ZIP 
        Gender  Grade Entering 
   Home Church (if any) 
        
Parent/Guardian Name(s) 
Parent/Guardian Address (or check here if same as student )
                 Street 
                   City  ZIP 
   Primary Phone Number 
 Secondary Phone Number 
         E-Mail Address 
                        You may receive occasional e-mail regarding this year's camp.
                        Your e-mail address will not be disclosed to any third party
                        or used for any other purpose.
                 
                Can the student bring a tent?  No Yes
   Does the student need transportation help?  No Yes
	                                       The cost of transportation is the responsibility of each student,
	                                       but we will do our best to help with transportation arrangements for
	                                       those who request it.

After submitting this registration information, remember to send the necessary camp fee and medical authorization and release form for each student.