EmailMeForm
2025 - YM Camp Leader Registration
June 16-20
Lake James State Park
Leader's Name
*
First
Last
Ward/Branch
*
Please Select
Bethania
Dobson
Lewisville
Mount Airy
Peace Haven
Pilot Mountain
Salem
Sparta
Stuart
Tanglewood
Winston Salem
T-Shirt Size
*
Please select
S
M
L
XL
XXL
Home Phone
*
###
-
###
-
####
Cell Phone
*
###
-
###
-
####
Email
*
Emergency Contact Name
*
First
Last
Emergency Contact Phone
*
###
-
###
-
####
Are you willing to teach a skill or run an activity at the Deacon's base camp (e.g., merit badge type activities)? If yes, please indicate, and if you have a particular skill or activity you are interested in, please note that too.
If you will NOT be attending the full camp dates, please note the dates you will be at camp.
