Youth Registration | Grandparent/Kid Camp | Online Payment | Scholarship Form STEP 1: CAMPER INFORMATION Camper Last Name Camp First Name Camper Home Address City State Zip Home Phone Email Gender Grade Completed this Spring Birthdate MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember STEP 2: FAMILY INFORMATION (PARENTS OR GUARDIANS) Parent / Guardian Name Relationship Parent / Guardian Name Relationship Parent / Guardian Address (If different) City State Zip STEP 3: PROGRAM INFORMATION Program Select Program STEP 4: PAYMENT INFORMATION & REFUND POLICY A $50 deposit is required to complete this regitration online. Registration deposits are non-refundable. Full payment is due by June 10. After June 1, additional fees paid will only be refunded for emergency or medical reasons. Discounts and registration deposit with be deducted from the final invoice. Discounts: Apply to week-long resident campers. Discounts for day camps are ½ that of full week programs. Family Camp and Grandparent/Kids Camp do not count as an additional week. Campers receiving Campership support to attend camp are not eligible for theses Discounts. Association Members Discount - if your congregation is a member of the Agape Ministry Association. Name and City of your congregation: CongregationBethany LC, Dormont (ELCA)Brighton Heights LC, Pgh. (NALC)Emmanuel LC of Eastmont, (Penn Hills) Pgh (ELCA)Faith LC, Laurel Gardens, Pgh. (ELCA)Faith LC, Upper St. Clair (ELCA)Grace LC, Steubenville, OH (ELCA)Grace LC, Troy Hill (NALC)Resurrection LC, Oakdale (ELCA)St. John LC, Carnegie (ELCA)St. Mark LC, Butler (NALC)St. Paul’s LC, Canonsburg (ELCA)St. Paul LC, Washington (ELCA)St. John LC, Connoquenessing (ELCA)Stewart Ave. LC, Pgh. (ELCA)Trinity LC, Gibsonia (ELCA)Zion LC, Brentwood, Pgh. (NALC) Sibling Discount - for each sibling for each of the siblings registered. Multiple Programs Discount - for full week program only if camper registers for more than one session. First Session is full price. Bring a Friend Credit – If a camper has been at Agape in the past, bring a friend, who hasn’t been to Agape before, and each of you receive a non-refundable credit to their Camp Store account. I would like to make an additional donation to the Agape Campership Fund $ Amount Paying Today $ Total Amount Due $ If you have a payment code, enter it here Does Camper have a sibling who is also registering? If yes, name: STEP 5: PARENT/GUARDIAN CONSENT By completing this online registration, you agree to the following:I support the policies, goals, and program of Camp Agape and herby give my child permission to participate in the programs and activities of the camp he/she may attend. Any photos or video recordings taken in which my child appears may be used for promotion of the camp free of any claims. I have read the refund policy and agree to the provisions stated there. Loading...
