Mountaintop Retreat - Summer Registration

Mountaintop Retreat - Christian Camping, Conference and Retreat Facilities

Camps

Summer Camp Info	Summer Registration
Goat Pack Info	Goat Pack Registration
Family Camp
Forms

Summer Camp Pre-Registration Form

Register early, camps fill up fast!

All information required for successfully submitting your online pre-registration is marked by *. After submitting your online pre-registration you will be taken to a confirmation page where you can submit your $10.00 (U.S.) pre-registration fee online, safely and securely, via PayPal

Please contact us directly by email or telephone for non-U.S. address pre-registrations!

Camper's Name*:

Address*:

City*:

State*:

Postal Code*:

Home Phone*:

Format ###-###-####

Cell Phone:

Format ###-###-####

Camper's Age*:

Camper's Birth Date*:

Month: Day Year

Camper's Gender*:

Male Female

Parent's Name(s)*:

Parent's Email Address:

Church Name*:

Please select the camp you desire to attend*:

Teen Camp Ages 13 - 18 :: June 13-18
Junior High Camp Ages 11 - 12 :: June 20-25
Junior Camp Ages 9 - 10 :: June 27 - July 2

Payment Information

Payment Details * (please make a selection):

I will send in the $10.00 Pre-Registration fee and pay the $90.00 balance on check-in day.
I will send in the full $100.00 payment with the Pre-Registration Form.
Scholarship - please first contact the camp office to request a scholarship for your child.

Note: this online form is only a PRE-REGISTRATION form.

A completed and signed Registration/Medical/Release form is required for your child to attend camp.