SUMMER CAMP 2015 REGISTRATION FORM
Camper Name________________________________________Age_______Male_____ Female ______ Church___________________________
Grade Completed in May 2015________ Years attended Cedar Crest Camp (circle) 1 2 3 4 5 6 7 8 9 10 or New Camper
Camper Address____________________________________________________ City_________________________State_____Zip_________
Mother Name/Guardian’s Phone (Home)______________________________ (Cell) ______________________ (Work) ________________________
Mother Address____________________________________________________ City_________________________State_____Zip_________
Father Name/Guardian’s Phone (Home)_______________________________ (Cell) ______________________ (Work) ________________________
Father Address____________________________________________________ City_________________________State_____Zip_________
EMAIL ADDRESS FOR PRIMARY CONTACT (forms will be emailed):______________________________________________________________________
CAMP SESSION SELECTED:
_________________________________
Camp Fee =
(Early Bird Rate ends April 10)
Less amount church to pay * =
$ ___________
$ -___________
=
$ ___________
*If church is to be billed, all information below
must be provided:
Pastor’s Name____________________________
Address_________________________________
City________________ St____ Zip___________
(*church name and billing info must be filled out for this deduction to be
accepted)
Phone___________________________________
I would like to donate to the following project(s):
Fax_____________________________________
Church Email____________________________
New Cabin Fund (enter amount)
$+___________
General Budget Fund (enter amount)
$+___________
Total cost
$=___________
Amount enclosed (with application)
$=___________
Charge approved* by
________________________________________
(*Approval signature must be of authorized
church official)
[Non-Refundable Deposit must be enclosed to reserve camp spot]
Check # ________ or if by credit card complete information in space provided.
or
**Credit card information:
Card # ____________________________________
3-digit security code: _____
ouExp Date: __/_____/___
Amt authorized to charge: $_______________
Signature: _________________________________________________________
Roommate Request for camper:
1)_________________________________________________________
2)_________________________________________________________
Other camper must put mutual request. NO MORE than 2 roommate requests per camper (Cedar Crest Camp official policy is that
no more than 3 campers from the same church/hometown will be placed in the same cabin/room in the spirit of Christian
community. They will still be together as direct neighbors as campmates. Please call for concerns or questions).
Summer Camp Options 2015
Early Bird Rate ends on April 10, 2015
Junior High Camps, Campers finishing Grades 6-8
Mini-Camps, Campers finishing Grades 1-2
Dates
Dates
Early Bird Rate
Regular Rate
Non-Ref. Dep.
JH#1 June 21- June 26
$330
$350
$100
JH#2 June 28- July 3
$330
$350
$100
JH#3 July 19- July 24
$330
$350
$100
JH #4 July 26- July 31
$330
$350
$100
Elementary Camps, Campers finishing Grades 2-5
Dates
Early Bird Rate
EC#1 June 14- June 19
$330
Regular Rate
Non-Ref. Dep.
$350
$100
EC#2 June 21- June 26
$330
$350
$100
EC#3 June 28 – July 3
$330
$350
$100
EC#4 July 5- July 10
$330
$350
$100
EC#5 July 12- July 17
$330
$350
$100
EC#6 July 19- July 24
$330
$350
$100
EC#7 July 26- July31
$330
$350
$100
Senior High Camp, Campers finishing Grades 9-12
Dates
Early Bird Rate
Senior High #1 June 15-June 20
Senior High #2 June 29- July 1
$330
$330
Early Bird Rate
Regular Rate
Non-Ref. Dep.
MC#1 June 14-June 16
$130
$160
$100
MC#2 June 17-June 19
$130
$160
$100
MC#3 July 12-July 14
MC#4 July 15-July 17
$130
$130
$160
$160
$100
$100
Outpost Camp, “rustic” camping experience in our hammock camp.
Dates
Early Bird Rate Regular Rate Non-Ref. Dep.
Elementary #1 Outpost
June 14- June 19
$340
$360
$100
$340
$360
$100
Junior High #2 Outpost
June 28- July 3
$340
$360
$100
Elementary #5 Outpost
$340
$360
$100
Elementary #6 Outpost
July 19- July 24
$340
$360
$100
Junior High #4 Outpost
July 26- July 31
$340
$360
$100
Junior High #1 Outpost
June 21- June 26
July 12- July 17
Regular Rate
$350
$350
Non-Ref. Dep.
$100
$100
7900 Cedar Crest Camp Road Lyles, TN
Phone 931-670-3025 / [email protected]
For questions regarding registration, scholarship, or payment, please contact the
office at 931-670-3025. For questions regarding summer programming, please
contact Director Russell Casteel, [email protected]
Don’t forget to register early while the Early Bird Discount is available!
Registration Forms must be mailed or emailed; no faxes will be accepted.