Leader Name *

First Name

Last Name

Phone *

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

Week 1: June 16-20

Week 2: June 23-27

Week 3: June 30 - July 4

Week 4: July 7-11

Week 5: July 14-28

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? *

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DD

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