Camp Blue Diamond
Summer Camp
Registration
Do Not register before Jan.1, 2010.
Registrations received before January will be invalid.
2010 CBD Registration Form Name Address
Ph#
Grade 09-10
Birth
/
/
Sex: M
F
Camper's Email Parent/Guardian
Work/Cell Phone Send confirmation/health forms by Parent's Email Roommate Request
1st
Choice Camp
2nd Choice Camp |
The camper agrees to abide by all regulations concerning personal conduct and use of camp property. Should it become necessary for the camper to return home, we will abide by camp's decision. We authorize CBD to photograph/video our child. Use of images will be limited to camp promotional materials, including; group photos, brochures and the website. Church Camp Fee $ Deduct Church Portion $ Deduct Scholarship Portion $
Balance Due: $ Method of Payment:
Check for $25, Extended payments |
To Submit this Form to Camp Blue Diamond, Using 1 of the 3 following methods:
1. Print the Form and Mail with your check or Credit/Debit card information to:
Summer Camp Registration
Camp Blue Diamond
P.O. Box 240
Petersburg, PA 16669
2. Print the Form and Fax to (814) 667-2152,
If paying by Credit/Debit card, Registration Forms will be processed immediately.
If paying by check your Registration will be processed after the check is received.
3. Highlight & Copy the Form and Email,
If paying by Credit/Debit card, Registration Forms will be processed immediately.
If paying by check your Registration will be processed after the check is received.