Camp 2022 Waitlist
Student's Name
*
First Name
Last Name
Which Church are you joining us with?
Westside: A Jesus Church
Bridgetown
Cedar Mill
26 West
Grace Chapel
Ekklesia
Imago Dei
Door of Hope
What grade are you in?
6th
7th
8th
9th
10th
11th
12th
Parent / Guardian's Name
*
First Name
Last Name
E-mail
*
This is the email we will contact you at once we have awarded scholarships.
Phone Number
*
-
Area Code
Phone Number
Submit
Should be Empty: