Register for Camp Meribah

Camper*

Email Address*

Address*

City*

State*

Zip*

Gender*

Age*

Last Grade Completed*

Phone*

Other Phone*

Adult or Youth T-Shirt*

T-Shirt Size*

Requesting Scholarship?*

Requesting Scholarship Amount

Camp Week* Day CampMini-MeribahYouth WeekTeen Week

Amount Due Today*

Pay All Camp Fees Now*

Note

I, the undersigned parent or guardian of the above mentioned, a minor, do hereby authorize the Centerville Church of Christ/Camp Meribah Staff to consent to any examination, treatment, and hospital care which is deemed advisable by a physician in the exercise of their best judgment and release Camp Meribah and its staff from all liability.

Electronic Signature*

Sign Date*

Camp Meribah Registration

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