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YOUR CART
MONITOR - Junior Camp
*
Indicates required field
Name
*
First
Last
Age during camp
*
Date of Birth 00/00/00
*
Gender
*
Male
Female
Registrant's Email (if applicable)
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone
*
Emergency Contact
*
Alt. Phone Number
*
Phone Number
*
Name of person paying via PayPal
*
PayPal email address
*
Church Name
*
Your Pastor's Name
*
Have you received the gift of the Holy Ghost?
*
yes
no
Have you been baptized in Jesus' Name?
*
yes
no
Have you been convicted of any crimes involving inappropriate behavior with children?
*
Yes
No
If yes, please explain:
*
List any known medical conditions the camp should be aware of:
*
List any medications that may be taken during camp:
*
Upload photo of yourself
*
Max file size: 20MB
Select T-Shirt Size
*
YOUTH S
YOUTH M
YOUTH L
YOUTH XL
ADULT XS
ADULT S
ADULT M
ADULT L
ADULT XL
ADULT 2XL
ADULT 3XL
ADULT 4XL
Please also print & fill out a registration form by visiting the printable files link.
This form must be signed by your pastor.
I agree to abide by all rules and guidelines that may be found on acofla.com
*
Yes
I agree to receiving marketing and promotional materials
Submit