Youth Camp Online Registration

Once you have registered online, we will send you an email confirmation and a medical  form that will need to be filled out and mailed back to our office. Please allow up to fourty-eight hours for process.

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Personal Info
Campers First Name
Campers Last Name
Address Line 1:
Address Line 2:
City:
Zip Code:
Phone Number:
EMail Address:
Amount of Deposit:
Camp Attending:	Sr. High 15-19yrs Summefest 19-25yrs Jr. High 12-14yrs Intermediate 10-11yrs Junior 7-9yrs
Payment Info
Credit Card Type:	Visa Mastercard
Credit Card Number:
Expiration Date:
3 digit Security Code:
Name on Credit Card:
Email Address:

ACKNOWLEDGEMENT / ELECTRONIC WAIVER

Once pressing the "Pay Now!" button, you acknowledge that you are sending an electronic contribution to the described event.

In addition, you agree to the following listed below, and you also acknowledge that you will receive an automatic email confirmation, within 72 hours,  letting you know that you electronic registration was successful. Thank you!

Please review the following:

• You agree to be charged the designated amount described above for a payment to Michigan Church of God Youth Camp.

• You release Michigan Church of God State Office and the online website from any liabilities of this electronic form, etc.