Registration Form

1 Registration Form
2 Review
3 Receipt

• = Required

PERSONAL INFO FOR CAMPERS AND MENTORS

I'd like to attend Camp U-CAN as... •

First Name •

Last Name •

Phone Number •

Email Address •

Mailing Address •

City •

State •

Zip •

Shirt Size •

Shoe Size •

Do you currently attend a church? If so, what church? •

STUDENT CAMPER DETAILS

Age (At time of Camp) •

School Grade (Fall 2022) •

Parent/Guardian Name (If Under Age 18) or n/a •

Parent/Guardian Email •

Parent/Guardian Phone # •

Do you have any additional special requests or needs? (FYI: Detailed medical/allergy information can be provided at a later date)

NEXT STEPS

After submitting your application, Camp Director Kelven Johnson will contact you with additional information. We are excited to see you at Camp U CAN!!

Camp U CAN

PERSONAL INFO FOR CAMPERS AND MENTORS

STUDENT CAMPER DETAILS

NEXT STEPS

Event Information

Contact Information