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* 1. Congregation Name:

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* 2. Contact Person:

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* 3. Phone:

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* 4. Email:

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* 5. Billing Address:

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* 6. City:

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* 7. State:

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* 8. Zip Code:

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* 9. FOR CONFIRMATION CAMP ONLY: Pastor/Youth Director led Study Time for Confirmation Camp is up to 1 hour per day.  If you choose Summer Staff-led Bible studies, they are done in village or herd groups. To help us plan camper housing and staff assignments, please check all that apply:

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