Wild Week Youth Camp at Latham Springs 2017 All fields required unless (otherwise stated) Your Name Title Church Name Mailing Address City State Zip Church Number Cell Number Your Email Contact Person (if not you) How did you hear about us? Total Number of Campers (Adults & Students) We will be attending (choose date) ---June 5-9 2017July 11-15 2017 I would prefer you contact me by: ---at Churchon CellEmail Have you personally been to WildWeek before? ---YesNo Has your church been to WildWeek before? ---YesNo Other Comments (optional) Now for the final test! Enter in the letters you see below in the box then click send. I have read and agree with the Financial Policies (Printed Registration Form) of Wild Week and have the authorization on behalf of my church to enter into this agreement.