Truth Bible Camp Registration Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Gender*Select OneMaleFemaleCamper Status*Select OneFull-Time Camper (age 12-18)Day Camper (age 9-11)Camper Age*Select One9101112131415161718Camper Date of Birth* Camper Phone*Camper Email* First Parent's Name* First Last First Parent's Phone Number*First Parent's Email* Second Parent's Name First Last Second Parent's PhoneSecond Parent's Email Emergency Contact* Please use parent information already listed. I would like to add an additional emergency contact. Emergency Contact* First Last Emergency Contact Phone*Camper's Physician* Physician Phone*Medical Information/Allergies/Anything else we need to know:Camper's T-shirt Size Youth L Adult Small Adult Medium Adult Large Adult XL Adult XXL Full Name of Church you attend: Has the camper been baptized? Yes No Is the camper a first-time camper? Yes No Pay Online Full-Time Campers Ages 12-18 ($25.00) Day Camper Ages 9-11 ($15) Total $0.00 Credit CardCard Details Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.