Wild Week Youth Camp at Latham Springs 2017
All fields required unless (otherwise stated)

Your Name


Church Name

Mailing Address




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)

I would prefer you contact me by:

Have you personally been to WildWeek before?

Has your church been to WildWeek before?

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.