Camper Registration Info

If younger than 13 or older than 18, please contact camp director at [email protected] for consideration.


Parent/Guardian Contact Information


Parent/Guardian #1



Parent/Guardian #2



Family Physician (optional)



Insurance Information



Emergency Information

In the event you cannot be reached, with whom may we consult regarding your child(ren) in an emergency? You must list at least one emergency contact.


In the "Details" box, please specify:

  • Step-parent or other adult living in house (not already listed)
  • Close friend or relative (who is aware he/she has been listed) who has permission and will be able to pick up the camper if necessary

Contact #1



Contact #2



Cancellation Policy


  • All registration forms and permission forms, along with a $25.00 non-refundable deposit, are due no later than June 1, 2019 to be eligible to attend camp ($25.00 is due at the time of registration).  

  • When we receive your registration with deposit, you will receive a confirmation e-mail at the e-mail address you provide.

  • The remaining balance of $300.00 is due by August 1, 2019.

  • Space is limited!  To guarantee your spot in the camp, you must pay a minimum of $150.00 toward your registration by June 1, 2019, otherwise, you may be bumped by those on the wait list.

  • If you cancel on or before June 1, 2019, then 100% of what you have paid up to that point is refundable, minus the $25 deposit.

  • If you cancel after June 1, 2019, then 50% of what you have paid up to that point is refundable, minus the $25 deposit.

  • If you cancel after July 1, 2019, there is no refund available.

If you have any questions regarding Messiah West Coast, send an email to [email protected]


Payment

$25 non-refundable deposit required for registration (total cost is $325 for early registration, and $350 for registrations after May 1st. Registration includes 5 nights lodging at Mile High Pines camp, all meals, activities, t-shirt, etc.)


  • (select this option to pay in full, or to make the $25 deposit)

If you would like to sponsor another child or make a donation, you can do so at shfarms.org/donate and please don't forget to indicate what your donation is for!


$0.00

You can download and fill out this form, please return this to us electronically!




RegFox Event Registration Software