Providing Places & Programs Pointing to Christ

P.O. Box 3, Prescott, AZ. 86302 - (928) 778-1690

Camp Aloma - campaloma.com

Online Registration 2012

Camper

First Name		Age
Middle Initial		Grade Entering
Last Name		Camper's Sex	M F
Home Church
Food Allergies

Address

Street
City		State		Zip
Phone

Camp

CAMP CHOICE		CABIN MATE REQUEST (same grade only)
		Name 1
		Name 2

Parent / Guardian

First Name
Last Name
Work Phone
Emergency #

Camp Fees

Camp Fee	$220.00
Early Bird Discount	$15.00
Sibling Discount	$	Sibling Name
Friendship Discount	$	Friend Name
Total Fees Due	$
Deposit	$	(minimum = $50.00)
(Your deposit applies to fee but is not refundable.)
Balance due at camp	$

Contact Information

Contact Name

Email