Camper Registration… « Camp Bethel Ministries « Wise VA

Once you have successfully completed and submitted this form you may pay online or print the payment form to mail with payment.

You must complete a registration form for each camper.

To avoid delay in processing, please fill out form completely...
Camper Information
Camper Last Name(required)
Camper First Name(required)
Address(required)
City(required)
State
Zip(required)
Gender
Date of Birth(required)
Age as of May 1, 2010
Grade completed by June 2010
Campers Email
Cabin Buddy?
Parental or Guardian Information...
Parents Names(required)
Parents Address(required)
Home Phone(required)
Other Phone
Parents Email(valid email required)
Other Adult Name(required)
Relationship
Church you attend
Assoc. Church Name (if coming with church)
Check any and all that apply...
RESIDENT WEEKS - the following require a non-refundable $50 deposit.
Jamboree / Ages 8-12 / June 14-19 / $275
Junior Week 1 / Ages 10-13 / June 21-26 / $275
Junior Week 2 / Ages 10-13 / July 5-10 / $275
Ultimate Teen / Ages 13-19 / July 12-17 / $275
Xtreme Teen / Ages 13-19 / July 19-24 / $275
DAY TREK WEEKS - Begins at 8:30AM and ends at 5:00PM each day and requires a non-refundable $50 deposit.
Jamboree / Ages 8-12 / June 14-18 / $175
Junior Week 1 / Ages 10-13 / June 21-25 / $175
Junior Week 2 / Ages 10-13 / July 5-9 / $175
Ultimate Teen / Ages 13-19 / July 12-16 / $175
Xtreme Teen / Ages 13-19 / July 19-23 / $175
ADVENTURE WEEKS - These weeks operate out of our Hickory Hollow facility in Bluff City, TN and require a non-refundable $50 deposit.
Adventure 1 / Ages 13-19 / June 14-19 / $275
Adventure 2 / Ages 13-19 / June 28-July 3 / $275
Adventure 3 / Ages 13-19 / July 12-17 / $275
DAY CAMPS - the following require a non-refundable $35 deposit.
Day Camp 1 - Bethel / Ages 4-8 / June 14-18 / $75
Day Camp 2 - Bethel / Ages 4-8 / June 28-July 2 / $75
DAY CAMPS at HICKORY HOLLOW - the following require a non-refundable $35 deposit.
These Day Camps are NOT listed in the Summer Camp Brochure. They were added after printing.
Day Camp 1 - Hickory Hollow / Ages 4-8 / June 21-25 / $75
Day Camp 2 - Hickory Hollow / Ages 4-8 / July 5-9 / $75
CommentsComments, Questions, Suggestions, Special Requests
Remember! Registration is not guaranteed until deposit or full payment is received...

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