DICKEY LAKE BIBLE CAMP ONLINE REGISTRATION
Please fill in all fields marked with a *
Camper Name
*
Address
*
City State & ZIP
*
*
*
Phone
*
Cell Phone
Email
Gender
Male*
Female*
Age
*
Grade Last Attended*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
Technical School
Camp Wanting to Attend
Work Week (Free)
Staff Training
Junior 1 July 8-11
Junior 2 July 14-18
JH Boys July 21-25
JH Girls July 28 Aug1
High School July 11 -14
Day Camp K-2nd Grade (TBA)
Men's Retreat Sept 5-7
Women's Retreat Sept 19-21
Heritage Days Aug 1-3
Winter Camp (TBA)
Ski Camp (TBA)
Art Camp (TBA)
Camp Bunk Buddy
Swim Skill Level
Can NOT Swim
A little
Fair
Good
Life Guard Certified
*
T-Shirt Size
A Small
A Medium
A Large
A XLarge
A XXLarge
Vegetarian Meals Requested
Needed
E Newsletter Request
Please Send Me Camp Newsletter
Emergency Name
*
Emergency Phone
*
Emergency Address
*
Emergency City
*
Emergency State
*
Relation
Parent
Sibling
Guardian
No Relation
*
Special Needs
Email Friend 1
Email Friend 2
Email Friend 3
Camp Attendance
1st Time
2nd time
More Than Twice
*
Send Email Updates
Please Email Me Camp Updates
Please Contact Me
Please Contact Me
