The Journey Church Registration Form

Please fill out this form and click submit.

Date

*

Church Name

*

Contact Name

*

Address

*

Email

*

This address will receive a confirmation email

Male Campers

*

Female Campers

*

Total Campers

*

We would like a private church dorm

Please select all that apply.

Boys $80 Girls $80

Shirts (Enter total Shirt Sizes)

Small

*

Medium

*

Large

*

X Large

*

2X Large

*

3X Large

*

4X Large

*

Payment (Total Campers x $30.00) Including Sponsors. Choose

Per Camper ($30) Mail Check (0) 2 Campers ($60) 3 Campers ($90) 4 Campers ($120) 5 Campers ($150) 6 Campers (180) 7 Campers ($210) 8 Campers ($240) 9 Campers ($270) 10 Campers ($300) 11 Campers ($330) 12 Campers ($360) 13 Campers ($390) 14 Campers ($420) 15 Campers ($450) 16 Campers ($480) 17 Campers ($510) 18 Campers ($540) 19 Campers ($570) 20 Campers ($600) 21 Campers ($630) 22 Campers ($660) 23 Campers ($690) 24 Campers ($720) 25 Campers ($750) $30 x Camper Total

Amount

**Make Checks Payable to The Journey Teen Camp**
If you choose to mail a check please send to Bick Gibbs 2709 Kingsdale Dr Deer Park TX 77536.
All churches will need to complete a camper form for each sponsor and camper by July 8th.
Follow the following link below: https://goo.gl/nAqjTe

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit.

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