Registration_and

Register to Beacon Bible Camp


Camp Session *	Cost: $ Dates:
Adults (17+) *

Children (3-8)
Youth (9-16)
Family Name *
Father's Name
Husband's Name
Mother's Name
Wife's Name *
Adult's Name	Sex * DOB
Adult's Name *	Sex * DOB
Adult's Name *	Sex * DOB
Child's Name *	Sex * DOB
Child's Name *	Sex * DOB
Child's Name *	Sex * DOB
Child's Name *	Sex * DOB
Childs Name *	Sex * DOB
Youth's Name *	Sex * DOB
Youth's Name *	Sex * DOB
Youth's Name *	Sex * DOB
Youth's Name *	Sex * DOB
Youth's Name *	Sex * DOB
Email *
Phone Number *	(no spaces)
Address1 *
Address2
City *
Province *
Postal Code *	(no spaces)
Church or Christian Gathering
Additional Notes
Do you accept the Code Of Conduct *	Yes No

	-- Once you click "Register", you will be transfered to a secure website to process your credit/debit transaction. -- You must have 128-bit encryption, cookies and java-script enabled to continue.