Your full name: Your email address: (e.g.: you@aol.com)
Your phone number (with country, city, area codes):
Age :
Date of Birth
1st Wk July 15-20
2nd Wk July 22-27
3rd Wk July 29-Aug 3
4th Wk Aug 5-10
Gender Male Female
Again, please keep in mind that the $60/week registration fee (non refundable) must be mailed to
before registration is considered final. Please make checks payable to Camp Berea and clearly indicate campers name on the memo portion of the check.
You will receive a medical form with your receipt, but if you need one quickly, you can get an online copy here
If you have any questions, please contact us at camp@berea4u.org