Adult Computer Camp Registration

Please complete this form and submit it. - Thank you!

(Please only register people at the same address together)

Select which Camp you would like to attend ---
Reg #	First Name:	Last Name:	Gender:
1
2
Street Address (include Apt#)---
City ---		Postal Code ---
Phone # ---		Alt Phone # ---
E-mail Address (if any) ---
Church Affiliation (if any)---