Grade Entering:

Gender:

First Camp:

Total Camp Fees:

PLEASE DOUBLE CHECK THE CAMPS TO MAKE SURE THEY ARE THE ONES YOU CHOSE

My checking of the box below certifies all of the above information is correct and will be updated if I move or change addresses before camp begins and gives permission for photographs of my camper to be used in camp publicity. My signature also yields permission for the camp to transport my camper in camp and private vehicles to and from public transportation or for an approved off-camp activity/trip along with permission to release health forms to health officials in emergency situations and in case of illness and injury. I also agree to compete and return the health form of my camper along with any other important registration material you receive after registration is confirmed. NYAC Outdoor Ministry Programs and Retreat Facilities are open to all persons regardless of race, religion, gender, sexual orientation, ethnic background, and national origins. Event Fees include a non-refundable $100 processing charge. No refunds will be made after May 1st.

I agree to the above statement

I disagree with the above and choose not to register at this time

Please Indicate how you will be paying.

Sending a Check in the mail

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