Grindstone Lake Bible Camp

Welcome to the convenience of online registration!

Register on or before May 1st and receive our Early Bird Discount ($5 off of your registration fee)!  

If you pay in full by May 1st you will also receive a 

FREE GLBC T-SHIRT!

Download a registration form for free!

I have already paid a deposit for a child/teen and 

would like to pay my remaining balance.

Please fill out the following questions.   Parents will only be contacted regarding their child's registration if their chosen week has already been filled.  Registration is at 4:30 PM on the first day of camp.  

Email Address

Camper First Name

Camper Last Name 

Sex Male Female

Age

Please place a check by the week that you wish to register.    Register before May 1st and receive our Early Bird Discount!

Please note that when registering online, there is a  processing fee included in your registration fee. 

*This camp is day camp from 8 AM - 6 PM.  Campers do not stay overnight.  

If attending day camp on July 26th-30th (K-2nd Grade), which day(s) do you plan to attend? (if signing up for other weeks, please skip this question)   

I would like to room with

Note: Camp does not normally honor group requests of four or more.

Birth Date of Camper (please use four digits for year)

Address

City         State     Zip

Name of Parent(s) or Guardian

Home Phone       2nd Phone      

Your Church

Church City

Denomination Alliance Assembly of God Baptist Catholic Christian Reformed Covenant Episcopal Evangelical Free Lutheran Methodist None Nondenomination (Community) Other Pentecostal Presbyterian

Has this child attend GLBC in the last three years? Yes No

Would you like to receive the GLBC News & Notes on a quarterly basis?  Yes No

Emergency Contact (other than parent)

Emergency Contact Phone

Insurance Carrier Policy No.

Physician's Name and Phone Number

Immunizations:

Date of Last Tetanus

Health History: 

Allergic to:  

List any activity restrictions and/or medication your child takes:  

Medical Release: Parents, please type your name below.  This typing of your name authorizes all hospital/medical treatment when deemed necessary by the camp for the welfare of the camper.  I am aware that my child may be used in promotional pictures.  The information on this form is correct to the best of my knowledge.  

Statement Verification

Name of Person Picking Camper Up

(This person will be required to sign out your child.)