Donating & Volunteering

Register Online Today!

Please fill out this registration for each camper you wish to register.

1. Camper Registration Information
First Name:
Middle Initial:
Last Name:
Address Line 1:
Address Line 2:
City/Town:
State/Province:
Zip Code:
Country:
Birthday:
Age:
Sex:	Male Female
Cabin Mate Request:
This space is for listing any friends of their child who are coming to the same session and allows them to stay in the same cabin. Note: children must be within one (1) year in age, and both families must list each other's child.

2. Select Which Session(s) Your Child will Attend (Choose all that apply)
	Camp Chickasaw #1: 6/3 - 6/8
	Camp Chickasaw #1: 6/10 - 6/15
	Youth Camp #1: 6/17 - 6/22
	Heroes Camp: 7/1 - 7/6
	Youth Camp #2 & LIT: 7/8 - 7/13
	Youth Camp #3 & LIT: 7/15 - 7/20
	Teen Camp: 7/22 - 7/27

4. Fill Out Parent/Guardian Contact Information
Mother or Guardian's Full Name:
Place of Employment:
Employment or Cell Phone Number:
Home Phone:
Email:

Father or Guardian's Full Name:
Place of Employment:
Employment or Cell Phone Number:
Home Phone:
Email:

5. Enter Billing and Payment Information
Refund Policy: The camp reserves the right to dismiss any camper for behavior that is detrimental to the welfare of the camp without a refund.
Parent /Guardian Full Name:
Billing Address Line 1:
Billing Address Line 2:
City/Town:
State/Province:
Zip Code:
Country:
Phone:
Email:

Select Which Payment Type You Prefer
	I prefer to pay by check. Please bill me with a paper invoice. I understand that my camper(s) will not be officially registered until a $100 required non-refundable deposit per camper per session for the upcoming camping season. By checking this box I hear by agree that the information I have submitted is 100% true and accurate. Your deposit will be credited in it's entirety towards the tuition fee. There is no separate registration fee.

	I prefer to pay by credit card. Please contact my by phone so that I may complete this registration with my credit card information verbally. By checking this box I hear by agree that the information I have submitted is 100% true and accurate. There is no separate registration fee.