2023 Application for Teenage Christian Camp Camper First Name:* Camper Last Name:* Birthdate (mm/dd/yy):* Gender:* Female Male 1st Year at Camp?:* Yes No Parent E-mail:* Camper E-mail: Address:* Address(cont): City:* State:* Zipcode:* Parent/Guardian Name:* Home Phone:* Cell Phone:* Emergency #s:* Church Preference:* Congregation Name:* Church Member?:* Yes No Immunizations Up-to-date?:* Yes No List Allergies Here... Allergies: List Health Issues Here... Health Issues: Group Number: Policy Number:* Insurance Carrier:* T-shirt Size?:* Camper S Camper M Camper L Adult S Adult M Adult L Adult XL Adult XXL Last Year Camper Was: Mr/Ms TCC Best Bible Boy/Girl -- Specify week awarded -- Week 1 - June 12th Week 2 - June 19th Week 3 - June 26th Week 4 - July 3rd Week 5 - July 10th Week 6 - July 17th -- Specify week awarded -- Week 1 - June 12th Week 2 - June 19th Week 3 - June 26th Week 4 - July 3rd Week 5 - July 10th Week 6 - July 17th TCC Registration Week(s) Attending:* 1 June 11-17 (ages 13-19) Camp Fee** $250.00 $200.00       $50.00
    Staff
Discount****   $100.00
  TCC/BB
Discount**** 2 June 18-23 (ages 8-13) $250.00 $200.00 3 June 25-30 (ages 8-13) $250.00 $200.00 4 July 2-7 (ages 8-13) $250.00 $200.00 5 July 9-15 (ages 13-19) $250.00 $200.00 6 July 16-21 (ages 11-15) $250.00 $200.00 **   The camp fee includes a t-shirt for every camper. A limited number of shirts will also be for sale at camp.
***  Full payment by June 7, 2023 is required to reserve a spot at camp and to receive the early discount rate.
**** 50% discount for Best Bible or TCC Award in 2022 (subtract $100.00); 25% staff discount (subtract $50.00); both
      subtract $125.00. NOTE: TCC, Best Bible and Staff Discounts are applied only to the early camp fee of $200.00. Total Amt: Fields that are marked with a "*" are required. Notes to Camp Staff: List Comments to Camp Staff Here... Please list below the names of anyone in addition to parents/guardians authorized to pick up this camper from camp: List Pick-up Authorizations Here... T-shirts will be distributed each camping week (additional shirts may be purchased for $10.00 per shirt at camp). * required field - must be completed. Scholarship Code:    Week
Sub Total Apply Scholarship to Week: -- Please select -- Day Camp Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Security Code:* Please, enter the text shown in this image into the Security Code field below. There are 6
letters/numbers in the image. You can click the green circular arrows to load a different image. Fee if paid in full
by June 7, 2023  $50.00
   Early
Discount*** Day Camp Registration - June 6-8 (ages 5-8) Fee $ 75.00 (No discounts are available for TCC Day Camp, scholarships may be available) Sub Total If you would like to make a donation to the camp master plan in addition to the camp registration fee, please enter that amount here: Please click ONCE and wait for Confirmation page