REGISTER

REGISTER.

You've made it to our registration page and are only minutes away
from being registered for the North East Worship Camp!

NEWC19 Medical Form
File Size:	189 kb
File Type:	pdf

Download File

PERSONAL INFORMATION

* Indicates required field

Student Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Gender *

Age *

Birth Date (MM/DD/YY) *

Student E-mail *

Parent / Guardian Name *

First

Last

Home Phone *

Cell Phone *

Parent E-mail Address *

Other contact in case of emergency *

First

Last

Home Phone *

Cell Phone *

Relationship to camper *

Person other than parent that child may go home with. *

Church *

Pastor's Name *

First

Last

Church Phone *

Church E-mail *

How did you hear about NEWC? *

MEDICAL INFORMATION

Please download and complete both pages of the Camper Medication form for NEWC 2019 (found at top of page).

IMPORTANT: All pages of the form must be filled out and signed by the teen, a parent/guardian, and the camper's Dr., P.A., or Pediatrician. If not completed, your child will not be able to attend camp.

Completed form can be mailed to: New Hope Fellowship, PO Box 96, East Bloomfield, NY 14443. Or submit a scanned copy via email to: neworshipcamp@gmail.com

MUSICIAN / SINGER INFORMATION

Primary Instrument *

Secondary Instrument *

When you have confirmed that all information is correct, please press submit and continue on to payment.

I agree to receiving marketing and promotional materials

Submit

PAYMENT

You can pay now by clicking the link to our Eventbrite registration page (online transaction fee of $10.23 applied during check-out). You may also send a check to our camp office:
PO Box 96, East Bloomfield, NY 14443.

Please make all checks payable to "NEW HOPE FELLOWSHIP”

NOTE: Your registration is not finalized and your spot is not confirmed until camper medication form and payment is received in full and our office has confirmed your registration by email. Please contact us with any questions you have.

EVENTBRITE CHECKOUT

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REGISTER.

PERSONAL INFORMATION

MEDICAL INFORMATION

MUSICIAN / SINGER INFORMATION

PAYMENT