Outdoor & Retreat Ministries - 262.245.6706 · orm@niccamp.org
NIC Summer Camp Registration Form - 2017
Complete & Print this form, then mail or fax it to the site hosting your selected camp (addresses at bottom of this page).  
Camper Registration
Select One Camp: @ Reynoldswood: J.O.Y.   Youth Serve   Woodland   Chicago Southern
@ Wesley Woods: Sailing 1   Family   Sailing 2   C.A.P.A.   CWaterSports
Camper's Name: First:     Middle:     Last:
T-Shirt Size: Youth-Medium   Adult-Small   Adult-Medium   Adult-Large  
Adult-XL  Adult-XXL  Adult-XXXL 
Birthdate: Month:     Day:     Year:
Entering Fall Grade: 2   3   4   5   6   7   8   9   10   11   12   13  n/a - Adult
Gender: Male   Female  
Your Home Church:
Church Town:
Request Up to 2 Cabin-mates (CM) Below:
CM 1:           CM 2:

Parent / Guardian
(for registration questions):
First:   Last:   Relation:
Phone 1: - -
Phone 2: - -
Text #: - -
Mail Address: P.O. Box / Street:
City:     State:     Zip:

Debit / Credit Card Payments
Name on Card: First:         Last:
Card #:     Card Security Code:The CSC/CSV/CVV is NOT your PIN number. It is an extra ID printed on your card. It appears on the back of Visa, MasterCard and Discover (3 digits), and on the front of American Express (4 digits).
Expiration: Month:     Year:
Billing Address:
City:     State:     Zip:
Signature:     Amount to Charge: ($50 Minimum)
By my signature above, I am instructing Outdoor & Retreat Ministries to charge the amount indicated (in the "Amount to Charge" box to the right of my signature), to my above-specified debit/credit card. If I neglect to specify an amount, I understand that it will be charged the non-refundable $50 deposit.

Please complete the above form and mail it to:
ORM Summer Camp
200 Stam Street
Williams Bay, WI 53191

If paying by check, make it payable to "NIC ORM" AND print your Camper's Last Name, First Name in the Memo Field.
Questions? Call 1-262-607-6104.