2022 Camper Registration
Camper's Name *
Grade (2022-23) *
Male or Female
Date of Birth
Parent or Guardian' Name *
Home Phone Number
I do hereby waive, release and discharge Nameless Creek Youth Camp, Inc. and their respective staff and volunteers from any and all rights and claims for damage resulting from injury to my person or property, which may be sustained or suffered in connection with my association with or participation in or arising out of participating in events at the camp.
We, the parent(s) hereby waive any claim for damages that may result in injury to my child,
*Please fill out all required fields.
Pin Camp 2022
PIN Camp is July 11-15, 2022. The camp has a limited number of spots. Camper to counselor ratio will be no more than 10 to 1. Total number of accepted campers will depend on available funding. All forms in the registration packet and $10 fee must be received by May 31, 2022. All potential campers will be notified of acceptance and/or of wait list status when all of their forms are received.
Questions directed to Brittany Bennett, Camp Director: Cell: 317-840-6130, email@example.com
Or, Jerry Bell, Cell: 317-652-2033, firstname.lastname@example.org
2675 S. 600 E.
Greenfield, IN, 46140
July 11-15, Mon - Fri
9:00 am – 4:00 pm