2023 Hume Summer Camp Ponderosa - High School

Parent Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Cell Phone:
• * Address 1:
• Address 2:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:

• Fee

  Type	Fee
  PAYPAL Deposit (All camps)	$310.00
  CHECK Deposit (All camps) - please send $300 by check in the mail	$300.00
  PAYPAL Full Payment (High school & junior high)	$975.00
  CHECK Full Payment (High school & junior high) - please send $950 by check in the mail	$950.00

Camper Information

• * Camper First Name
• * Camper Last Name
• * Camper Cell Phone
• * Camper Email
• *

  Camp attending:

  • Girls
  • Boys

• Camper's grade during 2023-2024 school year

  • 09
  • 10
  • 11
  • 12
  • High school graduate

• *

  Camper's School

  • Palos Verdes HS
  • Penninsula HS
  • South HS
  • Redondo Union HS
  • Loyola Marymount
  • Bishop Montgomery
  • Vistamar
  • Other
• * Camper's Birthdate (MM/DD/YYYY)
• *

  Camper Attends RuSH?

  • Yes
  • No

• *

  Is this the camper's first time to Hume Lake Summer Camp?

  • Yes
  • No

• You can request to be in the same cabin with up to 3 friends. We will try our best to honor your request. PLEASE ENTER ONLY ONE NAME PER BOX.

• Friend #1 Full Name
• Friend #2 Full Name
• Friend #3 Full Name

• If you have multiple children attending Ponderosa you will be able to register them at the same time. Enter up to 10 additional siblings by clicking on "add" in the Sibling section below.

Sibling Campers' Information

You may add a maximum of 10

IMPORTANT Registration Information

• We will notify you no later than Sunday, February 16 if you have a spot on the active list or the wait list. Camp fee will be $950 via check or $970 via PayPal (deposit is $300 via check or $310 via PayPal due by February 14th). Campership applications will also be available if a student is in need of financial assistance. Please contact luke@riversouthbay.org with any questions.

• **If you are paying by check, please remember to mail your check ASAP made payable to: The River Church of the South Bay 3525 Lomita Blvd., Suite 200 Torrance, CA 90505