Register For Camp Camp Registration Please carefully fill out this form for your camper to be enrolled at Deer Creek Adventure Camp for the term that best fits your schedule. Alternatively, you can sign up over the phone by calling (830) 589-7123. Camper's InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Camper's Date of Birth* Gender of Camper*MaleFemaleParent / Legal Guardian InformationParent / Legal Guardian's Name* First Last Relationship to Camper*Email* Enter Email Confirm Email Primary Phone Number*Work / Secondary Phone NumberEmergency Contact Name* First Last Emergency Contact Phone Number*Is the parent / legal guardian's address the same as the camper's address?*YesNoAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Camp SelectionI'm Interested In...*Adventure Camp One Week Term (Ages 7 - 13)Summer's Best Two Week Term (Ages 7 - 16)LIA (Leadership In Action) Term (Ages 17-19)Friends Week Term (Special Needs)Camp choices will appear once you have made a selection.I'm Interested in an Adventure Camp One Week Term ($875)*June 2nd - June 8th ::: Adventure Camp AC 1June 9th - June 15th ::: Adventure Camp AC 2June 16th - June 22nd ::: Adventure Camp AC 3June 23rd - June 29th ::: Adventure Camp AC 4June 30th - July 6th ::: Adventure Camp AC 5July 7th - July 13th ::: Adventure Camp AC 6July 21st - July 27th ::: Adventure Camp AC 8I'm Interested in Summer's Best Two Week Term ($1750)*June 2nd - June15th ::: Summer's Best SBTW 1June 16th - June 29th ::: Summer's Best SBTW 2June 30th - July 13th ::: Summer's Best SBTW 3July 14th - July 27th ::: Summer's Best SBTW 4I'm Interested in LIA terms ($1750)*June 2nd-June 15th ::: LIA Term 1June 16th-June 29th ::: LIA Term 2June 30th-July 13th ::: LIA Term 3July 14th-July 27th ::: LIA Term 4Are you a 2013 COR Team Member?*YesNoYour participation in the COR Team program is subject to verification.I'm Interested in Friends Week ($755)*July 29th-August 3rd ::: Friends WeekNotes or CommentsPlease Select a Method of Payment*OnlineMailTuition Total $0.00 Please verify all information and selections above.* I have verified all information above and acknowledge that the total amount provided is correct. If you have made any mistakes, please correct them now. If you discover that you submitted your registration with an error, please send the corrected information to pambehling@deercreekcamp.com Δ This iframe contains the logic required to handle AJAX powered Gravity Forms.
