Summer Camp Registration | Camp Mandaville

Summer Camp Registration Form

If your child would like to attend more than one week of camp please treat them as seperate campers for the purpose of this registration form. If you have one child that wants to come 2 weeks, you would register two campers.

Camp Registration Form summer 2023

- Step 1 of 4

How many campers are your registering? *

How would you like to pay? *

Financial Assistance

Please send me information on what is available for financial assistance.

Camper Information

Camper Name *

First

Last

Camper Gender *

Camper Birthdate *

Grade *

Base Camp (9-12 Grades) serving as junior helpers

Mini Camp (July 5-8) - $ 30.00
All Girls/Pioneer Boys (July 17-22) - $ 50.00
Mega (July 24-29) - $ 50.00

This is for young people interested in serving as junior leaders in a leadership training program. Please also contact the director at director@campmandaville.org for an application.

Week Desired *

July 5-8 – Mini Week (1-3 Grade) - $ 175.00
July 17-22 – All Girls (5-7 Grade Girls) - $ 265.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) - $ 365.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) - $ 290.00
July 24-29 – Mega Week (3-6 Grade) - $ 265.00
July 31- Aug. 5 – Teen Week (7-12 Grades) - $ 290.00

Week Desired (Deposit only) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 50.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 50.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 50.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 50.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 50.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 50.00

Week Desired (Pay Later) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 0.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 0.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 0.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 0.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 0.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 0.00

Does the camper have any known allergies or other medical conditions? *

Please explain (If allergy, is this food or airborne):

Check all that apply

This is my first summer at camp
This is my first time at camp
I have been to summer camp before
I plan to be a day camper only
I have siblings attending camp too
I was invited by a friend

Who invited you?

2nd Camper Information

2nd Camper - Name *

First

Last

2nd Camper - Gender *

2nd Camper - Birthdate *

2nd Camper - Grade *

Base Camp (9-12 Grades) serving as junior helpers

Mini Camp (July 5-8) - $ 30.00
All Girls/Pioneer Boys (July 17-22) - $ 50.00
Mega (July 24-29) - $ 50.00

This is for young people interested in serving as junior leaders in a leadership training program. Please also contact the director at director@campmandaville.org for an application.

Week Desired *

July 5-8 – Mini Week (1-3 Grade) - $ 175.00
July 17-22 – All Girls (5-7 Grade Girls) - $ 265.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) - $ 365.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) - $ 290.00
July 24-29 – Mega Week (3-6 Grade) - $ 265.00
July 31- Aug. 5 – Teen Week (7-12 Grades) - $ 290.00

Week Desired (Deposit only) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 50.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 50.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 50.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 50.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 50.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 50.00

Week Desired (Pay Later) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 0.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 0.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 0.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 0.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 0.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 0.00

2nd Camper - Does the camper have any known allergies or other medical conditions? *

Please explain (If allergy, is this food or airborne):

2nd Camper - Check all that apply

This is my first summer at camp
This is my first time at camp
I have been to summer camp before
I plan to be a day camper only
I have siblings attending camp too
I was invited by a friend

2nd Camper - Who invited you?

3rd Camper Information

3rd Camper - Name *

First

Last

3rd Camper - Gender *

3rd Camper - Birthdate *

3rd Camper - Grade *

Base Camp (9-12 Grades) serving as junior helpers

Mini Camp (July 5-8) - $ 30.00
All Girls/Pioneer Boys (July 17-22) - $ 50.00
Mega (July 24-29) - $ 50.00

This is for young people interested in serving as junior leaders in a leadership training program. Please also contact the director at director@campmandaville.org for an application.

Week Desired *

July 5-8 – Mini Week (1-3 Grade) - $ 175.00
July 17-22 – All Girls (5-7 Grade Girls) - $ 265.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) - $ 365.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) - $ 290.00
July 24-29 – Mega Week (3-6 Grade) - $ 265.00
July 31- Aug. 5 – Teen Week (7-12 Grades) - $ 290.00

Week Desired (Deposit only) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 50.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 50.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 50.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 50.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 50.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 50.00

Week Desired (Pay Later) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 0.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 0.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 0.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 0.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 0.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 0.00

3rd Camper - Does the camper have any known allergies or other medical conditions? *

Please explain (If allergy, is this food or airborne):

3rd Camper - Check all that apply

This is my first summer at camp
This is my first time at camp
I have been to summer camp before
I plan to be a day camper only
I have siblings attending camp too
I was invited by a friend

3rd Camper - Who invited you?

4th Camper Info

4th Camper - Name *

First

Last

4th Camper - Gender *

4th Camper - Birthdate *

4th Camper - Grade *

Base Camp (9-12 Grades) serving as junior helpers

Mini Camp (July 5-8) - $ 30.00
All Girls/Pioneer Boys (July 17-22) - $ 50.00
Mega (July 24-29) - $ 50.00

This is for young people interested in serving as junior leaders in a leadership training program. Please also contact the director at director@campmandaville.org for an application.

Week Desired *

July 5-8 – Mini Week (1-3 Grade) - $ 175.00
July 17-22 – All Girls (5-7 Grade Girls) - $ 265.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) - $ 365.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) - $ 290.00
July 24-29 – Mega Week (3-6 Grade) - $ 265.00
July 31- Aug. 5 – Teen Week (7-12 Grades) - $ 290.00

Week Desired (Deposit only) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 50.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 50.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 50.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 50.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 50.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 50.00

Week Desired (Pay Later) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 0.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 0.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 0.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 0.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 0.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 0.00

4th Camper - Does the camper have any known allergies or other medical conditions? *

Please explain (If allergy, is this food or airborne):

4th Camper - Check all that apply

This is my first summer at camp
This is my first time at camp
I have been to summer camp before
I plan to be a day camper only
I have siblings attending camp too
I was invited by a friend

4th Camper - Who invited you?

5th Camper Information

5th Camper - Name *

First

Last

5th Camper - Gender *

5th Camper - Birthdate *

5th Camper - Grade *

Base Camp (9-12 Grades) serving as junior helpers

Mini Camp (July 5-8) - $ 30.00
All Girls/Pioneer Boys (July 17-22) - $ 50.00
Mega (July 24-29) - $ 50.00

This is for young people interested in serving as junior leaders in a leadership training program. Please also contact the director at director@campmandaville.org for an application.

Week Desired *

July 5-8 – Mini Week (1-3 Grade) - $ 175.00
July 17-22 – All Girls (5-7 Grade Girls) - $ 265.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) - $ 365.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) - $ 290.00
July 24-29 – Mega Week (3-6 Grade) - $ 265.00
July 31- Aug. 5 – Teen Week (7-12 Grades) - $ 290.00

Week Desired (Deposit only) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 50.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 50.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 50.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 50.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 50.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 50.00

Week Desired (Pay Later) *

July 5-8 – Mini Week (1-3 Grade) $175 - $ 0.00
July 17-22 – All Girls (5-7 Grade Girls) $265 - $ 0.00
July 17-22 – All Girls w/ horse (5-7 Grade Girls) $365 - $ 0.00
July 17-22 – Pioneer Boys (5-7 Grade Boys) $290 - $ 0.00
July 24-29 – Mega Week (3-6 Grade) $265 - $ 0.00
July 31- Aug. 5 – Teen Week (7-12 Grades) $290 - $ 0.00

5th Camper - Does the camper have any known allergies or other medical conditions? *

Please explain (If allergy, is this food or airborne):

5th Camper - Check all that apply

This is my first summer at camp
This is my first time at camp
I have been to summer camp before
I plan to be a day camper only
I have siblings attending camp too
I was invited by a friend

5th Camper - Who invited you?

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Relationship *

Parent
Sibling
Relative
Friend

Name *

First

Last

Email *

Phone *

Phone (2)

Address

Address Line 1

Address Line 2

City

State

Zip Code

What church are you associated with, if any?

Additional Comments or Requests

Parent Authorization

I give my permission for my child to participate in all camp activities. I realize camping activities can be dangerous and accept these risks. I hold harmless & indemnify Mandaville Camp & Retreat Center and BCM Int’l from all liability for injuries sustained from my child’s participation as a camper. The Mandaville staff is permitted to act in my behalf in authorizing unexpected medical care for the above named minor during their stay at camp, understanding that the camp will notify me when such care is needed in a timely manner. I also give permission for photos & media clips of my child to be used for camp promotion.

Full Name - by typing your name here you are signing the above statement *

Camp T-shirt

Butterfly Design Camp t-shirt - $ 10.00
Lion Design Camp t-shirt - $ 10.00

Please select the size below if ordering a shirt. If you plan to order a shirt, please order it now so we can have the proper quantity.

T-shirt Size (Shirt Sizes run about a size big)

Youth 8-10 (Small)
Youth 10-12 (M)
Youth 14-16 (Large)
Adult (Small-Men's Cut)
Adult (Small-Women's Cut)
Adult (Medium- Men's Cut)
Adult (Medium -Women's Cut)
Adult (Large-Men's Cut)
Adult (Large-Women's Cut)
Adult (XL-Men's Cut)

Total

$ 0.00

Stripe Credit Card *

Card

Name on Card

Download a pdf copy of our application here.