Mt. Gilead Bible Camp + Conference Center

Summer Camp 2010 Reservation

Please fill out this form completely.

Please Note: Our Registration form is in process. This form will reserve your space at camp but further information will be required to complete registration. We appreciate your continued patience as we update our website.

 

Our Complete Online Registration will be available by Monday, March 15th.


If you are concerned about Internet Security, please view our Security page.

Camp Attending

Jr. Camp: Entering 4-6 grade
Jr. High Camp: Entering 7-8 grade
High School Camp: Entering 9-graduated
Please specify the camp you'd like to register for.
First Name Camper's Name is required.
Last Name Camper's Name is required.
Address
City
State
Zip
Home Phone
(Ex.: 707-823-4508)
Email Address
Required: A confirmation notice will be sent to this email address		 An email is required.
Home Church
(If applicable, otherwise, use "none")
Gender

Grade

 

 

Deposit Information
Cost

High School Camp $411

Junior High Camp $390

Junior Camp $345
Optional Items Avail for Pre-Order

Weekly Highlights DVD ($18.00)
Group Photo ($5.00)
Theme Shirt ($12.00)
Amount to Charge Now
The minimum, non-refundable registration fee is $50.00
Card Type
Credit Card Number
(Ex.: XXXX-XXXX-XXXX-XXXX)
Expires
(MM/YY)
V-Code
Last 3 digits on back of card
Name as it Appears on Card