On-Line Registration Form
                Directions for Online Registration:
1.  Fill out the form below and click "Submit"  (Only one entry per person please)
2.  Campers use PayPal button to submit payment.  Note :  If you have trouble with PayPal, you can come back       
       to  this  page and simply choose the PayPal button to try again.  No need to fill out form again)
3.  If you register online, you must bring a signed Registration Form and a signed Recreation              
     
Waiver form with you to camp.
Name of Camper:
Age
Address:
Telephone #
Parent/Guardian Name:
Church Name/City:
Payment Method:
Camper Fee:
$250.00
PayPal
Check
Credit
Card
Forms for Printing
Note:  Anyone wishing to be a counselor must fill out a background check form. We will contact you to
let you know if you have been approved.  The background check form is mailed to:
Rev. Don Jacobsen, 216 North French St, Arlington, WA 98223.  The Counselor Application form is
mailed to:  Rev. Jeremy Painter, 7629 Oak Park DR NW, Bremerton, WA  98311
Payment Method
Check: Please include camper's names along with payment and mail to:
    Youth Secretary, PO Box 3894, Silverdale, WA 98383.
PayPal: Please include a $3.00 fee per camper and also enter the names of the campers when
reviewing your payment in the "Name" area provided.
Credit Card: Please fill out separate credit card form and mail to Youth Secretary.