Camp Lutherhaven, Indiana 2008 Online Summer Registration Form
(One registration per camp program)

  1. Complete either the "Register Camper" section or "Register Family" section below.

  2. Fill out the "Complete Contact Information" section.

  3. Click the "submit button" to send this registration form to Camp Lutherhaven, Indiana and be taken to a secure payment site to make payment with your credit card or electronic check online. 
    (If you do not want to use your credit card or electronic check online, please use the mail-in form.)

Register Camper
(For all children/youth programs)
Last name:
First name:
Current grade ('07/'08):
Birthdate: ( _ _/_ _/_ _ )
Sex: M F
Parent(s)/guardian(s):
Program name:   1st choice)
                 Alternate choice)
Roommate preferences: 1st)
                                         2nd)
Counselor preference:
 continued below at contact information

      -OR-

Register Family
 (For Family, Father/Son, Mother/Daughter, and Kindercamp)
Participants' names (first & last)

M or F

 Birthdates ( _ _/_ _/_ _ )
MF
MF
MF
MF
MF
MF
Camp program desired:
Housing preferences: 1st)
                                      2nd)
Roommate preference (for F/S or M/D):

 

Complete Contact Info

  

Make Payment
Address:  

You will need the following three amounts to enter on the next payment screen.

  1. Your desired camp program's deposit or full payment.

  2. The amount of camper bank money, if any, you would like to deposit for your child. (N/A for family camps, Tri-C camp, or Servant Events)

  3. Five dollars for the optional Camp Photo if you would like to purchase one. (N/A for family camps or the developmentally disabled camp)


Clicking 'submit' below will send this registration form to Lutherhaven, Indiana and take you to a secure payment site where you can pay with your credit card or electronic check.
(If you intended to register for Camp Lutherhaven, Idaho go here)

After submitting your registration and payment,
you will receive a payment confirmation via email momentarily and a Camp confirmation within a few weeks. 
When you're ready, hit 'submit'.
 
City:  
State:  
Zip:  
Phone:  
E-mail:  
Would you be willing to receive confirmation materials via Email?
Yes  No		  
 
 
 
Home church:  

Church city/State:  

Check here to request financial aid.
 For Financial Aid Information - click here