2025 Capernaum Day Camp

WHERE: Hope Presbyterian Church, Richfield, MN

WHEN: August 12, 2025 - August 14, 2025

DepartureTime: 8 am

Return: Between 4 and 4:30 pm

COST: $ 300 (A deposit of $ 100 is required to hold your spot.)

Money is nonrefundable after July 31, 2025

After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information

Contact Shari Wormwood, [email protected] or Call/Text 612-756-1918

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($300.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$0 Deposit ($300.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.
Transportation fee ($25.00)
Covers transportation to/from Day Camp for all three days.

Participant Name

Date of Birth

Phone

Phone Type

Participant Address

If you will drive your son/daughter, can you drive a few other students each day?

Gender

Male
Female

Allergies or special needs during the day

Ethnicity

T-shirt Size

School

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

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Phone Type

Parent/Guardian Email

Address is same as participant*

Address

Would you like to cover the 2.5% processing fee?

Credit Card Process Fee

$0.00

Total

$0.00

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Billing Information

Name

Payment Method

Cash/Check/Offline

Please enter billing information, which may be different from above.

Address

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