Youth in Service Summer Camp - Registration
Please fill out this form and click submit.
Head to our website to
learn more
.
Participant's Name
*
Participant's Age
*
Participant's Current (2024-2025) Grade Level
*
Please select all that apply.
6th
7th
8th
9th
10th
11th
12th
Participant's T-shirt Size
*
Please select one option.
XS
S
M
L
XL
XXL
Select Option
XS
S
M
L
XL
XXL
Please list any food allergies organizers should be aware of.
*
Parent/Guardian Name
*
Email
*
This address will receive a confirmation email
Phone
*
Payment
$100.00
Please read and check all boxes to acknowledge and accept that you are informed of the program's requirements.
*
Please select all that apply.
I understand that this camp is planned for each participant to attend every day (excluding illness) because of our commitment to the service organizations we are visiting.
I understand that participants will need to provide their own lunches.
I understand that additional forms, such as permission slips and medical forms will be sent via email and must be returned by June 1st for participant to attend camp.
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following