Youth Camp 2021: Reflect

July 21-24 | Fill out this form to register for Youth Camp 2021!

Name

*

Email

*

This address will receive a confirmation email

Parent's Email

This address will receive a confirmation email

Phone

*

Church

*

Please select one option.

Lakeview Christian Center: New Orleans Christ Community Church: Covington Other

Name of Church if not listed above

Grade Completed

*

Please select one option.

6th 7th 8th 9th 10th 11th 12th

T-Shirt Size

*

Please select one option.

XS S M L XL XXL

Please print and sign the two documents below and turn them in before camp.
Code of Conduct
Medical Release Form

Payment $200

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 21-24

Fill out this form to register for Youth Camp 2021!

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