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Camper Name
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Date of Birth
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Gender
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Address
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City/State/Zip
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Parent Guardian name
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Home Phone(s)
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Emergency Phone(s)
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Preferred Attendance Date:
Please select Date
July 7-11
July 14-18
July 21-25
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Camp times:
Please select Camp time
half day $125
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Camp locations:
Please select Camp location
Sonoma (Adventist Church, 20575 Broadway)
Sebastopol (Ragle Park)
Redding
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Email Address:
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Does your child Requires
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Special Health Care: