Camper Pre-Registration 2021 First Name * Last Name * Address * City * State * ZIP * Camp Week * Jr High (Grades 6-8) June 6 - 11 Sr High (Grades 9-12) June 13 - 18 Junior (Gardes 3-5) June 20 - 24 Day Camp (Grades 1-2) June 26 (Saturday) Beloved Camp (Grades 7-12, Girls) July 10 - 11 Deeper Life (Grades 7-12) July 11 - 16 Multiple Weeks:Multiple Weeks: Birth Date * Home Church Camp T-Shirt size * Child Medium Child Large Adult Small Adult Medium Adult Large Adult X-Large Email of parent or guadian: (confirmation notice will go to this address.) * 2021 Camper Pre-Registration Fee $25.00 * Pay now with PayPal (Includes service charge) Pay by Mail-in Check Total Total to PayPal Total to Pay by Mail-in Check Full Registration Form and Balance of Fee must be presented at check-in or earlier. Thanks. Mailing address: MLCC Registration, P.O. Box 188, Horton, KS 66439 Emergency Contact Name (First, Last Name) Emergency Contact Number Telephone Number (xxx) xxx-xxxx Additional comments (arriving late, leaving early, etc.) To prevent spam, please complete the box below. Thank you. If you are human, leave this field blank.