Camper's first and last names:

*

Birthdate:

*

Age:

*

Gender:

Male Female *

Grade next fall:

*

Parent(s) name(s)

*

Home phone (include area code outside ND):

*

One parent's work phone:

*

Mailing address (PO Box? Use it.):

*

City:

*

State:

Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *

9-digit zip code:

*

Home congregation:

*

City/town:

*

Pastor:

*

Cabin mate - optional
We accommodate cabin assignment requests with one friend, but we cannot guarantee cabin assignments with more than one friend.

When possible, roommate requests will be honored. We ask that campers request only one roommate. To be paired together, each camper must request the other on his or her registration form. Please do not create “chains” of roommate requests. Groups of four or more will be separated in order to assure all campers in each cabin experience Christian community.

Name of one cabin mate:

Choice	Name of Camp Session	Session Number
example	Pioneers	II
1st Choice	*	*

Please select one:

Returning camper First-time camper *

Family Plan
Second child's fee will be reduced by $10.00, third child's fee by $10.00, etc. Complete Family Plan portion only if applicable. List only names of camper's brothers and sisters who will also attend camp.

Sibling's name(s):

Email address:

*

Our/my child has permission to participate in normal camp programs at Camp Metigoshe on- or off-site. Metigoshe Ministries has our/my permission to use photos and/or slides that may be used for promotional purposes.

Our/my child's registration for the named camp session will be confirmed when we/I recieve a receipt of registration, a Health History and Medical Information/Parent Permission form, an informational pamphlet (what to bring, schedule of arrival/departure, directions, etc.). If the aforementioned has not been received at least 10 days prior to the scheduled camp session, I understand that I should notify the business office (701) 263-4788 to obtain them.

Checking the box signifies that you have read and understood the above statement:

*

Payment
A deposit of $50 is required in addition to completing this registration. After submitting your registration form you will be directed to the Payments page where you will be able to pay the deposit. You must continue and pay the deposit otherwise registration will be incomplete.