Leader Name *

First Name

Last Name

Phone *

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Select the week(s) of camp you'd like to attend. *

Dates will be added once registration opens.

Week 1

Week 2

Week 3

Week 4

Week 5

Submitting this form notifies Crossroads Summer Camp of my interest. Until I hear from Crossroads regarding availability, these spots are not reserved. *

I understand.

When will you be ready to pay deposits? *

MM

DD

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