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Name
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First
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Address
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City
State
Zip Code
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Email
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Phone Number
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Emergency or Alt. Phone
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Church
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Pastor
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Plan to stay during
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Junior Camp
Senior Camp
Dates planned to stay
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Number of "plugged in" nights
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2
3
4
5
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19
20
Must enter this number again in your Paypal shopping cart.
Type in the amount due $20/night
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Type of RV Trailor
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Comment
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Payment Options
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I will pay online via PayPal
I will mail in a check
I will pay in person
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