Youth Camp Registration Form

There are three ways to register for camp:

  • Register here online.
  • Call Delta at (315) 336-7210
  • Print out this form and mail or fax it to the office  Click Here 

Camper's Name:

Address:

City and State:     Zip Code:

Home Phone:

Email:

Gender:   Male      Female

Date of Birth:

Grade (Fall of 2010) :

Name of Parent / Guardian: 

Work Phone:

Attended Camp Before At Delta Lake:   Yes      No

Roommate Request (s)  - Maximum of 2:

         

Church the Camper Attends:

How Many of Your Children are Attending Delta Lake's Youth Camps this Summer?

Camp Attending:

Payment Options:

Note: Registration is not complete and forms will not be mailed until the registration fee is received.