NE Bible Camp 2008 Online Registration Form

 Completely fill out this form before you click the "SUBMIT" button below.
(once you Submit you cannot change or retrieve the information)
To move between fields: Use "TAB" NOT "Enter".
(using "Enter" on some browsers is the same as clicking "SUBMIT")

Head of House, Parent or Guardian who is filling out this form.
(please also repeat your name and other information below if you are attending camp)
First Name Last Name Phone Number #1 Phone Number #2
Address Email address
City State Zip Home Church

FIRST PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:
Tshirt size:    Tshirt quantity
First choice for housing for this person
Second choice for housing for this person

SECOND PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

THIRD PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

FOURTH PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

FIFTH PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

SIXTH PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

SEVENTH PERSON in Family attending camp
First Name Last Name   Male  - Female Housing Special Instructions:
Share cabin with what family?
Date of Birth Age Grade next year
Other housing, explanation:
Home Church Christian
If you have a medical need for electricity or indoor plumbing please explain it here:

Tshirt size:    Tshirt quantity

First choice for housing for this person
Second choice for housing for this person

Registration Fee Calculation

IMPORTANT NOTE: In the following sections, calculations are NOT performed automatically.  Please fill in ALL blanks that apply.

Age # people Late Registration