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2026 Youth/Young Adults Camp Getaway

First Name

*

Last Name

*

Phone Number

*

Email Address

*

Gender

*

Gender

A

Male

B

Female

Church Branch

*

Age Range

*

Marital Status

*

Marital Status

A

Single

B

Married

Are you a student?

*

Are you a student?

A

Yes

B

No

Field of work (E.g. Healthcare, IT or Business)

*

Please indicate how your camp expense of $216.96 will be covered:

*

Please indicate how your camp expense of $216.96 will be covered:

A

I will pay the full fee

B

I have confirmed my branch will cover the full fee

C

I have confirmed my branch will cover part of the fee

D

I require assistance with covering part of the fee

E

I will pay the full fee & I can support at least one other person

Do you have any food or substance allergy?

*

Do you have any food or substance allergy?

A

Yes

B

No

Any comments or questions?

*