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CCCJ 2026 Winter Camp: Imago Dei

First Name *

Last Name *

Gender *

Male

Female

Grade *

6th

7th

8th

9th

10th

11th

12th

College

Adult

Camper's or adult's cell phone number *

Camper's or Adult's Email *

T-shirt Size *

S

M

L

XL

XXL

Camper Parent's or Adult's Name *

Camper Parent's or Adult's Phone Number *

Camper Parent's or Adult's Email *

Parent or Adult's Signature *common.clear

Please list any food allergies or concern here (Or "NA" if not applicable)

Two ways to pay *

Check to CCCJ (note: WInter Camp)

Zelle transfer to cccjfl@gmail.com

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