Student Name *

First Name

Last Name

Guardian Name *

First Name

Last Name

Guardian Phone *

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Please write a check for down payment with "Winter Camp -Student's Name-" in notes. For the check, I prefer to...

Hand deliver to Pastor Ryan or Pastor Harold

Mail in to Asbury (Asbury UMC, 6101 University Ave, Madison, WI, 53705, ATTN: Winter Camp)