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2011 Camp Friedenswald Youth Camp Online Form
No Deposits Required. Full payment due on or before arrival (payment in any form will be accepted early). If you choose to pay by credit card please call Friedenswald at (269)-476-9744 to make that transaction with in 10 days after registering.
1.	Youth Camp High School (June 13-18) Nature Adventure (June 13-118) Junior Music (June 13-18) Senior Music (June 13-18) Primary (June 20-22) Junior High (June 20-25) Pre Junior (June 27-July 2) Junior (July 4-9)
2.	Name:
3.	Email:
4.	Parent/Guardian
5.	Gender female male
6.	Date of Birth
7.	Grade Completed in 2010-11
8.	Address
9.	City
10.	state
11.	Zip Code
12.	phone number
13.	Church
14.	cabin mate request
15.	Special needs/other:
16.	I hereby certify that the above information is accurate and I give my permission for the use of photographs and videos of my child and myself to be used in Camp publicity and for my child to be transported to and from off-camp activities; for the release of medical records in case of illness or inury; and for this camper to engage in all camp activities, except as noted by me and/or an attending physician. (type your name in the place of signature)