Camper Registration | Jump-In Camps

Camper Registration Form

Click here if you have already registered and want to pay the balance of your camp fee.

Camp cost is $125 per camper. (Please contact NW Signs and Wonders Camp at 541-912-4774 if you have more than 2 campers attending camp.) A $25 non-refundable deposit is due with registration. The remaining balance must be received by June 30th or camp fee will be $150. A Health Care Form will be emailed to you once you register. You will need to fill it out, sign it, and send it back to NW Signs and Wonders Camp in order to complete your registration. If you choose to send a check please make it payable to Jump-In and mail to: NW Signs & Wonders Camp, 7501 S. Knights Bridge Road, Canby OR 97013. Jump-In Northwest is a non-profit organization partnering with IHOP Kansas City.

Date
Child's Name *
*	MF
Child prefers to be called
Address *
Address *
Home Phone *
Date of Birth *
Age *
Grade in Fall of 2011 *
Father's/Guardian Full Name
Father's/Guardian Cell Number
Mother's/Guardian Full Name
Mother's/Guardian Cell Number
Family Email Address * (Registration confirmation will be sent via email)
Alternate Email Address
Church
Name of 1 or 2 friends your child would like to share a cabin:

T-Shirt Size - Child *	XSSMLXLAdult Small
I would like to be on the general mailing list: YesNo
* Who may pick up your child from Camp?

Please list any persons your child is NOT allowed to leave with:

* I give my permission for photographs from camp that include my child to be used in future publications or electronic media: YesNo
* Method of payment: I am paying with a credit card or paypal account using paypal (You will be provided a paypal link, once you submit the registration form) I am sending a check in the mail.
* fields denoted with an asterisk are required

Jump-In Summer Camp -