Skip Navigation

Register

If you would prefer a printed form or would like a brochure sent to a friend or relative please email Jim Buzza, jimbuzza@luther.edu or call 563.387.1389.

  • Camper Information
  • Participation
  • Payment

Camper Information

First Name:*
Last Name:*
Gender:*
Address:*
City:*
State/Province:*
Zip:*
Home Phone:*
E-mail:*
School:*
Grade completed by June 2014:*
Requested Roomate: Males, one name
Females, one or two names