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2011 SUMMER CAMP
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Online Registration is now open!
     
 

IMPORTANT INFORMATION
Please make sure you have read our 2011 Camp Registration and Information page before you submit the Registration Form below.

You should also know the following information before submitting the Registration Form:

  • Which session of camp will your camper be registering for?
  • Do you know how much you will owe for your camper's session of camp? If your home church helps pay for sending your camper to camp - then subtract the amount your home church will pay from the total tuition fee for the session and add any prepaid missions giving to know the amount you will owe. If your home church contributes nothing, then you will owe the full amount of tuition for your session. You will make your payment on the PayPal website after you submit the form below.
  • Do you have your home church information? We will need to know the name of your camper's home church, the name of your camper's minister and the church phone number. We will also need the name of the church that you are registering through, if other than your own church.
  • Do you know your dorm choice? You can choose between the Campbell complex or the Dorm on the Hill. Your choice will be considered on a first come basis. If requesting a roommate, please be sure to request the same dorm.
  • Does your camper desire to room with anyone specific? If so, you will need to know the name of the person your camper wants to room with. Your camper and the desired roommate must register on the same day to guarantee rooming together provided space is available.
  • What size T-shirt will your camper need?
  
     
 
 
     
 
Online Registration is now open!

Please DO NOT leave any field blank.  Any information that is not applicable please type "N/A" or "None."

CAMPER INFORMATION

Last Name:
First Name:
Middle Name:
Street Address:
Address (cont.):
City:
State:
Zip:
Phone:
E-mail:
   
Date of Birth:

 
Gender:
 
Age:
 
Grade in School as of Spring 2011:
 
Father/Guardian (Custodial)
  
Last Name:
First Name:
Work Phone:
Cell Phone:
 
Mother/Guardian (Custodial)
  
Last Name:
First Name:
Work Phone:
Cell Phone:
 

 

CHURCH INFORMATION

Have you been baptized (immersed): Yes No
Year Baptized:
Home Church:
Pastor's Name:
Church Phone Number:
Sponsor Church
(if not home church) :
Sponsor Church Phone Number:

 

CAMP INFORMATION

Choice of Session:
  (Please note the price of the session you select as you will need to enter this as the amount to pay on the PayPal website.  Please pay full amount not covered by your church/scholarship plus any prepaid missions giving.)
   
T-Shirt Size:
Dorm Choice:
Desired Roommate (Must register at same time)
Last Name:
First Name:

 

EMERGENCY/MEDICAL (if unable to contact parents)

Non Parent Emergency Contact:
Relationship:
Emergency Phone #:
Emergency Cell #:
Medical Card:
Health Problem:
 

Epilepsy/Seizure Disorder
Asthma
Diabetes
Sleepwalk
Allergies

(please specify ALL allergies in box above)

Camper has NO known health problems
Tetanus:
Tetanus Date:
Tylenol/Advil:

 

PAYMENT INFORMATION

Payer or Cardholder's Name:
Registrations received without payment will not be processed.
(Please note you will NOT be charged from this page.  This information helps Hilltop ensure that the correct monies and mission offerings are applied to the appropriate camper)
   
Tuition:
Enter the amount of tuition minus any scholarship paid by your church, if any.
(You can find the tuition amount in the CAMP INFORMATION section above - under the selection you have made for "Choice of Session")
Mission:
   

("Click calculate button")

 
Total:
(This is the amount you must enter in the "donation" box on the PayPal website.
You will be directed to that site after you successfully submit this form.)

 

Please be sure that NO AREAS ARE LEFT BLANK.  In areas that are not applicable or the answer is unknown please be sure to put "N/A" or "None."