Love, Joy, Peace...
Cornerstone COG Melbourne
Youth Camp Form
Name (
Required
)
Email Address (
Required
)
Your Phone Number (
Required
)
Age Group (
Required
)
Middle School
High School
Emergency Contact (
Required
)
In the event of an emergency, who do we contact? Phone number?
Allergies or Medical Info (
Required
)
What is your T-Shirt Size? (
Required
)
Small
Medium
Large
Extra Large
Camper Birthday (
Required
)
January
February
March
April
May
June
July
August
September
October
November
December
Address (
Required
)
|
Do you have a Room Mate Preference?
Camper First and Last Name (
Required
)
Any additional concerns that may be needed
Submit
Cornerstone COG Melbourne
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