Please complete this form completely before submitting. You will receive a confirmation e-mail when we have received your registration.

Please register for only one summer camp!

Camp Selection
Camp:	-- Select -- Family/Teen Fall Retreat (all ages) Winter Retreat (ages 15-19)
	NOTE:  If the camp you're looking for isn't in the list, then it is already full!

Camper Information
Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone Number:
Birthdate:
Gender:	-- Select -- Female Male
I'd Like to Bunk With (one name please):
First Time at SBL:	-- Select -- No Yes

Additional Information
E-mail Address:
Emergency Contact:
Emergency Number:
How Did You Hear About SBL:
Church Affiliation:
Comments: