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 2015*
Requested Roomate
  • Males, one name
  • Females, one or two names