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2023 Summer Camp Registration
Please fill out and submit this form to register your camper for summer camp. If you have multiple campers to register, you must fill out a separate form for each.
23
Questions
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1
What week is your camper attending?
*
This field is required.
July 9-14 - Luther Glen Farm - Confirmation Camp - Grades 6-9
July 16-21 - El Camino Pines - Summer Camp - Grades 2-10
July 23-28 - El Camino Pines - Summer Camp - Grades 2-10
July 30- August 4 - Luther Glen Farm - Farm Camp - Grades 2-10
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2
Camper Name
*
This field is required.
First Name
Last Name
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3
Camper Date of Birth
*
This field is required.
-
Date
Month
Day
Year
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4
Gender
*
This field is required.
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5
Grade (Fall 2023)
*
This field is required.
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
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6
Home Congregation & City (if applicable)
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7
Home Address (Street, City, State, Zip)
*
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8
Email
*
This field is required.
example@gmail.com
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9
Parent/Guardian #1 (Name & Relationship)
*
This field is required.
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10
Parent/Guardian #1 Phone Number
*
This field is required.
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11
Parent/Guardian #2 (Name & Relationship)
*
This field is required.
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12
Parent/Guardian #2 (Name & Relationship)
*
This field is required.
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13
Is your camper attending camp with a friend? Please enter any cabin-mate requests.
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14
Does your camper have any allergies?
If yes please example on the next page.
YES
NO
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15
If yes, please explain the allergy and the severity.
If no allergies just press "next."
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16
Does your camper have any dietary restrictions?
YES
NO
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17
If yes, please explain.
If no just press "next."
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18
Photo Use Waiver
*
This field is required.
Your photo or your child’s photo may be taken for use in camp promotional literature. Your child would only be identified as a camper, not by name. You can either allow us to use photos of your child, but waive the right to inspect or approve the photo if used for such purposes, or prohibit the camp from using your child's photo.
Yes, you may use photos of my child.
No, you may not use photos of my child.
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19
Activity Release Waiver
*
This field is required.
I hereby give permission for this camper to participate in the programs and all activities of Lutheran Retreats, Camps & Conferences. Programs and activities include but are not limited to hiking (easy to moderate levels), rock wall climbing (easy to moderate), archery, swimming (levels determined by swim test administered on site) and other outdoor activities that will vary based on the participants abilities. I agree LRCC will not be held responsible for accidents or personal injury arising there from. I will submit a health history form two weeks prior to camp and if necessary, documentation of a recent physical exam. I give the camp staff permission to seek medical treatment for my child in case of illness or injury.
I have read AND understand the above and agree to the above. Please sign your name below.
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20
Terms & Conditions
*
This field is required.
I hereby give permission for this camper to participate in the programs and all activities of Lutheran Retreats, Camps & Conferences. I agree LRCC will not be held responsible for accidents or personal injury arising there from. I will submit a health history form two weeks prior to camp and, if necessary, documentation of a recent physical exam. I also agree to pay the deposit after submmiting this form.
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21
"You Choose" the price you pay for your camper!
*
This field is required.
New for Summer 2023, you can choose the price that works best for you and your family.
Full Price - $530
No Price - $0
Half Price - $265
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22
How would you like to pay?
If you are paying by check please mail to LRCC Admin Office 39136 Harris Rd. Oak Glen, CA 92399. If paying by credit card you will be redirected after you submit this form to our website and payment portal.
Check
Credit Card
My Church Will Pay
No-Price
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23
Please select the amount being paid today. (You will redirected to the CC payment page after you submit this form.)
If you are paying by check please mail to LRCC Admin Office 39136 Harris Rd. Oak Glen, CA 92399. If paying by credit card you will be redirected after you submit this form to our website and payment portal.
(Registrations are not final until the deposit is paid.)
Full Price Full Payment - $530
Full Price Deposit - $200
Half Price Full Payment - $265
Half Price Deposit - $100
No Price - $0
My Church Will Pay
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2023 Summer Camp Registration
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