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2024 DAY CAMP REGISTRATION FORM

Day Camp Logo

Ages 4 - Entering 6th Grade

June 24 - 28, 2024

9:00 a.m. - NOON

Canaan Bible Chapel

30 Hemlock Road, Lake Ariel, PA 18436

(Across from the Western Wayne Middle School)

To register, please complete all of the requested information below.

Required fields are marked with an asterisk *

Family Information:

How did you hear about Day Camp?*
Answer Required

Emergency Contact Information:

Emergency Contact's Relationship to Camper(s)*
Answer Required

Camper #1 Information:

Gender*
Answer Required
Please identify the grade into which this camper will be going this Fall.*
Answer Required
Does this camper have any food allergies?*
Answer Required
Does this camper have any known medical issues with which we should be aware?*
Answer Required

If there is more than one camper from this family, please continue by filling out information for the remaining campers.  Otherwise, scroll to the bottom of the poage, give you email address and select "submit" to complete registration.

Camper #2 Information:

Gender
Answer Required
Please identify the grade into which this camper will be going this Fall.
Answer Required
Does this camper have any food allergies?
Answer Required
Does this camper have any known medical issues with which we should be aware?
Answer Required

If there are no other campers to register, scroll to the bottom of the page, give your email address and select "submit" to complete registration.  Otherwise, continue filling out the information in the next section.

Camper #3 Information

Gender
Answer Required
Please identify the grade into which the camper will be going this Fall.
Answer Required
Does this camper have any food allergies?
Answer Required
Does this camper have any known medical issues with which we should be aware?
Answer Required

If there are more than three campers which you are registering, please submit this form and then create another complete registration form for the remaining campers.

Confirmation Email