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2009 Registration




Register for Summer Camp
Some camps are filled or filling; please check below before registering.
Bullet View Registration Fees

Register for Grandfolk/Littlefolk Day

Arrow Arrow  Overnight Youth  Campers Begin Registration Here   Arrow Arrow


General Information For ALL Overnight Youth Campers

Is this your first time at a CCCC-sponsored camp?
Camper's Name: 
Camper's Gender:  Male  Female 
Camper's Birth date: 
Mailing Address: 
Parent/Guardian's Name: 
Home Phone: 
Parent's Work Phone: 
Camper's School: 
Camper's grade in school on May 1, 2009:

Choose T-Shirt Size:
(Free T-shirts for all
overnight campers!)


Church (if any): 
Cabin mate Request:
One person only.  Honored only if
campers request each other.


Select 2009 Camp you plan to attend:
Please choose the camp reflecting the grade you are in on May 1, 2009.

1st-2nd grade camp, June 15-16 Contact camp office before registering a girl for this camp.

$75

3rd-4th grade camp, June 17-19 Contact camp office before registering a girl for this camp.

$105

4th-5th grade camp, June 21-26

$180

5th-6th grade camp, June 28-July 3 Contact camp office before registering a girl for this camp.

$180

7th-9th grade camp, July 5-10 Contact camp office before registering for this camp.

$190

Wilderness Camp (grades 9-12), July 13-17 Registration for this camp is closed.

$210

*Early Registration discount no longer applies.*

Parent's E-mail Address:
Must have email address for confirmation purposes.

Does your church pay any toward camp fee? 
If so, how much? 

Bring a Friend Discount:
Return campers who bring a friend who has never attended summer camp at CCCC receive $10 off for each friend up to $50 off.  If you qualify, please list names of new campers.  Your friend must attend the same week as you and will take the place of a cabin mate request.  Does not apply to 1st-2nd grade campers.

Parental Consent
Photographs are taken during summer camp.  If you DO NOT want pictures including your child to be used for camp publicity, please check here.

"I affirm that all information on this registration form is complete and accurate to the best of my knowledge."
Name of parent completing form must be included here.  You may use this space for other comments if needed.
• To be eligible for Early Registration, $35 non-refundable deposit must be mailed by May 18, 2009.  Maximum cost for families sending more than one child to camp is $500.

To prevent spam, please enter the first four letters of the name of your camper here:. (These letters MUST be the same as what you entered under Camper's Name above.)   
Financial assistance through the Crooked Creek campership fund is available to anyone who needs it. All inquiries will be kept confidential.

I would like financial assistance
Amount I am able to pay.
 
Your registration is not complete until camp receives this on line registration and the $35 deposit via US Postal Service.  Confirmation letter and health/medical release form will be mailed to you upon receipt of both items.

Campers will not be permitted to leave camp for ball games or other activities and return to camp.  Contact camp office for information on emergency situations.
 

2830 Coppock Rd, Washington, IA 52353  •  Phone: (319) 653 - 3611  •  Fax: (319) 653 - 3611

Southeast Iowa Mennonite Camping Association