Register Online

Please enter information in the form below.  We will send out a confirmation packet with a medical form, packing list, and directions to camp stating that your place is being saved for one week from the receipt of this form pending your non-refundable, non-transferable registration fee of $80 which must be sent to:

Cortland Bible Club Camp
P.O. Box 100
Pitcher, NY 13136

First Name Last Name Middle Initial

Street

City State Zip

Phone E-Mail

Male Female First Year Camper Age as of June 1

 Camp Week / Age /  Date / Cost
Week of Camp

Home Church

Requested Bunkmate (only one)

Parent's Name

Work Phone Cell Phone



 

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