Camp Joy Retreat Registration



Please do not press tab or enter while filing out registration form. Thank you.

Camper Information
Full Name:
Street Address:
         City, State & Zip: ,   
Phone Number: (###) ###-#### -
Email Address:


Retreat Information
Retreat or Outing you're attending:
Dates of the Retreat or Outing: -
I am planning on staying in: Standard Room Deluxe Room
Driftwood Village Condo Motel


Register other campers:
 Example: Register your son to accompany you during the Fishing Outing.

Second person's full name:
Age if a minor:
Third person's full name:
Age if a minor:
Fourth person's full name:
Age if a minor:
Fifth person's full name:
Age if a minor:
Sixth person's full name:
Age if a minor:
Seventh person's full name:
Age if a minor:
Eighth person's full name:
Age if a minor:
Ninth person's full name:
Age if a minor:
Tenth person's full name:
Age if a minor:
Eleventh person's full name:
Age if a minor:


Church Information
Church:
Pastor's Name:
Church's Street Address:
City, State & Zip: ,   
Church Phone Number: (###) ###-#### -
Church's Email Address:


Authorize Medical Statement
Please note: I give Camp Joy my consent to secure any necessary medical treatment for my family and me during the camping period. I also authorize any qualified physician to render treatment he or she deems necessary upon consultation with the camp staff. I authorize over-the-counter medication to be provided by the healthcare staff. I realize my insurance will be billed for any medical treatment as the primary coverage for me.
I authorize:  
Today's Date: ##/##/####   
When the registration process is completed, please print off the medical statement and have
it signed by a parent or gaurdian. It must accompany each camper at the time of registration.
Thank you.

You will receive an email conformation after this step.