Teen Camp Parents 2024

Please complete this online registration for each camper separately. Please note: Registration is not complete until payment is received. Payment can be mailed by check to address below (ONE CHURCH CHECK PER GROUP). * If church is mailing check, please mark "PAY LATER"

Send Checks to:
Travis Stamper
1245 McClure Rd
Columbus, IN 47201

Camper check-in begins at 1:00pm-1:30 pm on Monday, July 1, 2024.

Location for Youth Camp:
Shiloh Park
1950 S. 350 E
Marion, IN 46953

Parent Information

- Parent Information needed with easiest way to contact you if needed

* Parent/Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Email

* Parent/Guardian Mobile Phone

* Local Church

* Parent/Guardian Address

* Parent/Guardian City

* Parent/Guardian State/Province

* Parent/Guardian Zip/Postal Code

* Name of Emergency Contact

* Emergency Contact Phone #

Medical Information

- Please fill out all medical information completely.

* Medical Insurance

* Medical Insurance Phone

* Insurance Group #

* Insurance Policy #

* Number of teens attending

Parent Information

Medical Information

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