• Home
  • About
  • Programs
  • Photos
  • Facilities
  • Get Involved
  • Contact Us

2010 Registration




Register for Summer Camp

Bullet View Registration Fees

Register for Family Camp

Register for Grandfolk/Littlefolk Day

If you prefer you may click here to print out a mailable form; our address is at the bottom of THIS page. Please DO NOT mail in a registration AND register online.

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, 2010:

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 2010 Camp you plan to attend:
Please choose the camp reflecting the grade you are in on May 1, 2010.

1st-2nd grade camp, June 14-15

$75 
 

3rd-4th grade camp, June 16-18*

$105
 
*This camp is nearing capacity. Contact camp office before registering your child for 3rd-4th grade camp.    

4th-5th grade camp, June 20-25

$180
 

5th-6th grade camp, June 27-July 2

$180
 
*Contact camp office before registering a girl for 5th-6th grade camp.    
6th-8th grade camp, July 4-9 $185  

7th-9th grade camp, July 11-16

$190  

Wilderness Camp (grades 9-12), July 19-23

$210  

*Early Registration discount is no longer valid*

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 10, 2010.  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