When: June 3-7

Where: Camp Bethel, Wise VA 

Total cost: $325

Due Today: $75 non-refundable deposit

You have to be actively attending 5PT YTH to go. 

IMPORTANT:

• You will be required to upload pictures of the front and back of your medical insurance cards while filling out this form. Please have your card (or pre-existing images of your card) available before you start.
• Upon completion of this form, you will receive a separate email for each student with a special link used to gather an electronic signature on the Medical Authorization Form.
  
• For the above two reasons, it is highly recommended that you complete this form using your mobile phone.
• Do NOT use the SecureGive mobile app or the church website to pay for this event. You will be emailed payment reminders with a special online payment link.
  
• If your student has prescription medications, this form must be printed, filled out, and brought with you when you supply prescription medications to the camp nurse.