Register for Lake Luther

Camp Week/Program at Lake Luther

Camper's First Name

Last Name

Parent's Name

(with last name, if different)

Postal Address

City / State / Zip

Cell Phone

Cellphone for parental contact

Contact Email

All camp info will be sent to this address; it is also your username for future logins

County

Gender

Entering Grade

First Time Camper?

Birthdate

Blank, or MM/DD/YYYY (all 4 digits of year)

Buddy Requests

Name of up to 3 friends that you would like to share cabin with

Church Affiliation

Congregation

Name of the Church I Attend

Enter the name of your church

Emergency Contact

Who to CALL in event of emergency during camp

Emergency Phone

Questions / Concerns / etc