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Winter Camp Registration
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Winter Camp Registration
Winter Camp Registration – Grades 7-11
How many siblings are you registering for camp?
(Required)
1
2
3
4
5
Discounts apply only when siblings are registered together in the same household.
State of residence
(Required)
MO
AR
OK
NM
Campers
Camper First Name
Camper Last Name
Gender
Grade Level
Actions
Edit
Delete
There are no
Campers.
Add Camper
Maximum number of campers reached.
Section Break
Parent Contact Information
Parent/Guardian First Name
(Required)
Parent/Guardian Last Name
(Required)
Relationship
(Required)
Mother
Father
Other
Phone
(Required)
Email
(Required)
Total Amount
(Required)
Price:
$0.00
Payment Method
(Required)
Credit Card
Zelle
Credit Card Processing Fee
Price:
$0.00
Zelle: arculturedialog@gmail.com
Zelle Confirmation Number
(Required)
Zelle Payment Date
(Required)
MM slash DD slash YYYY
Payment Plan
(Required)
One time payment
Pay in two installments
Final Payment Amount
(Required)
Price:
$0.00
Credit Card
Cardholder Name
Card Details