2024 Teens Summer Camp Application

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Teens (Age 12* - 16) July 3th – July 7th
*12 year olds must be finishing 7th grade and have been coming to teens service to register for teens camp.

Camp Location:
Conference & Retreat Center
5605 Jubilee Dr SE, Turner, OR 97392

If you have any questions please call:
Stanislav Velichko (503) 805-3599
Dennis Panfilov (360) 513-7929

Instructions:
1. Complete form by May 20th
2. Provide payment information: $140 per child
3. Submit

Notes:
School buses will be used for transporting teens to and from campsite.

Please note: our summer camps are for members only, there will be no refunds if the applicant's parents are non-members.

Name

Please Upload a Profile Photo

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Address

Gender

Male Female

Date of Birth

Age at time of camp

12 13 14 15 16

T-Shirt Size

XSmall Small Medium Large XLarge

Father's Name

Father's Phone Number

Mother's Name

Mother's Phone Number

Emergency Contact & Phone Number

What church are the parents of the applicant members of?

Sulamita Other

If other, please provide the name:

Does applicant have allergies to any medications?

None Claritin Visine (eye drops) Tylenol Ibuprofen Benadryl Other

If yes, please specify:

Does applicant have any seasonal/other allergies?

Yes No

If yes, please specify:

Will your child bring any medications from home?

Yes No

If yes, please specify:

Specify any special conditions or needs staff needs to be aware of

None Health/Physical/Medical Eating Sleeping Swimming Other

If there are any please elaborate:

Camp Waiver Link Doc

Electronic Signature (Participant's Full Name or Full Name of Legal Guardian if Participant is Under the Age of 18)

This address will receive a confirmation email

Teens Camp Registration $140

Please consider donating to "Teens Ministry" to help support families that are not able to cover registration for all their children. Click here to donate in a new window.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2024 Teens Summer Camp Application

Description

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