Getaway Camp Registration

Please register your attendance for Getaway Camp

List Names of ALL Registrants

Hit the “+” on the right side of the page to add additional registrants to the form

First Name (as it will appear on a nametag)

Last Name (as it will appear on a nametag)

Grade Entering in the Fall (if applicable)

Address (Billing Address)(Required)

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Emergency Contact

First and Last Name

Phone Number

Home Church

Traditional Thursday Night Pig Roast – Adult Pig Roast Tickets ($10/ticket)

13 years old and older – Please type desired quantity – To be paid at time of Pig Roast in the LCC Office – Graciously prepared by the Neal family

Traditional Thursday Night Pig Roast – Child Pig Roast Tickets ($5/ticket)

12 years old and younger – Please type desired quantity – To be paid at time of Pig Roast in the LCC Office – Graciously prepared by the Neal family