Form

Mother Daughter Camp Registration
All registrations must be accompanied by a non-refundable $20 deposit. Deposits can be banked to: Camp Columba Committee, West Pac 03 0915 0252118 00
Mother's Name:
Mailing Address:
Home Phone:
Cell Phone:
Email:
Daughter's Name
Daughter's Birthday
Month Day Year
Daughter's Name
Daughter's Birthday
Month Day Year
Mailing Address #2 if living in separate addresses:
Emergency Contact:
Home Phone:
Cell Phone:
Please list any medical or dietary conditions that we should be aware of:
All registrations must be accompanied by a $20 deposit but you are welcome to pay in full at this time.
Payment Method:*
Payment Amount:*
That's all the information we need. Please click the submit button below. You will be getting a confirmation package in the mail from us within a week. Can't wait to see you at camp!
Should be Empty:

Mother Daughter Camp Registration