Camp Registration Form

Correspondence and questions, including registration, refunds, cancellations, etc. should be directed to the Camping Registrar at 785-249-9720 (cell) or 785-272-7622 (office) or at rcagrizzly@aol.com.

Camp Location
Selection One
Select ONE camp from the Dropdown Menu
Additional T-Shirts are available at checkout.
Camper Name *
Camper Name
Date of Birth *
Date of Birth
Select the grade the camper will go into this coming fall
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Contact Phone *
Parent/Guardian Contact Phone
Home Address *
Home Address
Attended ABCCR Camp Previously *
Let us know if this is the first time attending an ABCCR Camp.
List below there four things: 1) Church Name; 2) Town of Church Location; 3) Name of Pastor; and 4) Name of Prayer Partner.
Please list in the area below any Special Needs, Health Issues, Dietary Restrictions etc. If there are none, please type NONE.
Parent / Guardian Authorization to Attend *
By marking AUTHORIZE and your name below, you certify the following: I give permission to ABCCR to use photographs of campers for promotion. I give permission for my child to participate in the challenge course and climbing tower while at camp. I release the Central Region Camping Program, the camp, and all employees, staff and volunteers of the camp, and any affiliates from liability and risks associated with participation in the low-elements challenge course at Cross Wind and the climbing tower, air-soft, and zip-line at Camp Christy.
Have you submitted and application for and anticipate receiving an ABCCR Camp Scholarship for 25% of the Early Bird Registration Fee? Select below:
$
$
June Camps must be registered by May 1 to receive the Early Bird Discounted Fee (NO EXCEPTIONS) July Camps must be registered by June 1 to receive the Early Bird Discounted Fee (NO EXCEPTIONS)
$

You can now PAY ONLINE for camp registrations.  Once you click SUBMIT above, you will receive confirmation of receipt of your registration.  You can go to PAYMENTS and pay online for the camp registration.