Camper Registration

Select Camp Name

Select Camp Name (Discounted)

How Many Adults?

How Many Children?

Camp Starts

Camp Ends

Camp Starts

Camp Ends

Camp Starts

Camp Ends

Camp Starts

Camp Ends

Camp Starts

Camp Ends

Camp Starts

Camp Ends

Camper Information

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

First Camper

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

Second Camper

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

Second Camper

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

Third Camper

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

Fourth Camper

Camper First Name

Camper Last Name

Birth Date

Gender Gender

T-Shirt Size

I Would Like to Bunk With:

Family Information

Parent First Name

Parent Last Name

Adult 1 First Name

Adult 1 Last Name

Adult 2 First Name

Adult 2 Last Name

Adult 3 First Name

Adult 3 Last Name

Adult 4 First Name

Adult 4 Last Name

Address

City

Province

Postal Code

Country

Cell Phone

Email

Newsletter

Receive newsletter and next years camper registration information?

WE ARE OFFERING A 20% DISCOUNT ON ALL REGISTRATIONS UNTIL DEC. 31!

Fees Due:

Preliminary Medical Form

Please Note: A full comprehensive health form is required 30 days before the start of camp. Fill out online.

Family Health Card Number:

Individual Health Card Number:

Second Family Health Card Number:

Second Camper Individual Health Card Number:

Family Health Card Number (If Applicable):

Individual Health Card Number:

Third Camper Individual Health Card Number:

Forth Camper Individual Health Card Number:

Second Family Health Card Number (If Applicable):

Second Camper Individual Health Card Number:

Third Camper Individual Health Card Number:

Forth Camper Individual Health Card Number:

Allergies? Explain:

0 of 250 max characters

Any special dietary needs?:

0 of 250 max characters

Any other medical problems?:

0 of 500 max characters

Any physical or mental challenges?:

0 of 250 max characters

Payment Options

Payment methods

Online Payment

E-Transfer Payment

If you choose to pay by e-transfer, please send the amount from the 'Fees Due' field to the email address camp@rocklake.com with the subject line: "[Camper First and Last Name] Camper Program Fee Payment."

Online Payment

First Name

Last Name

Billing Email

Billing Address

City

Province

Postal Code

Country

Payment

REGISTRATION FORM

Camper Information

First Camper

Second Camper

Second Camper

Third Camper

Fourth Camper

Family Information

Preliminary Medical Form

Payment Options

E-Transfer Payment

Online Payment

ROCK LAKE
UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

ROCK LAKE
UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

ROCK LAKE
UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

REGISTRATION FORM

Camper Information

First Camper

Second Camper

Second Camper

Third Camper

Fourth Camper

Family Information

Preliminary Medical Form

Payment Options

E-Transfer Payment

Online Payment

ROCK LAKE UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

ROCK LAKE UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

ROCK LAKE UNITED CHURCH CAMP

FOLLOW US

STAY UP TO DATE

ROCK LAKE
UNITED CHURCH CAMP

ROCK LAKE
UNITED CHURCH CAMP

ROCK LAKE
UNITED CHURCH CAMP