Home arrow Register Online!
Online Registration E-mail

To Register online:



  1.  Download 2011 Carol Joy Holling Camp Early Bird Flier
    File Size:203.06 Kb



     Download 2011 Sullivan Hills Early Bird Registration & Schedule
    File Size:530.35 Kb

  2. Choose your session
  3. Fill out and submit the form below
Fill out the information below completely. The fields with a * are required fields and must be completed in order to submit the form. The following payment information will be transferred through a secure internet transaction. If you have questions about this process, please call NLOM toll free at 1-888-656-6254. Your registration form will not be processed without payment of your deposit.

 

Camper Information
Camper's First Name
required field
Camper's Last Name
required field
Grade Completed
required field
Gender
required field
Date of Birth
required field
Camper t-shirt size:
Number of previous years as a camper at CJH or Sullivan Hills
required field
Preference for housing mate
How did you hear about CJH or Sullivan Hills?
Does the camper have any exceptional needs?

Parent Information
Parent/Guardian's First Name
required field
Parent/Guardian's Last Name
required field
Address
required field
City
required field
State
required field
Zip Code
required field
Home Phone
required field
Cell Phone Number
E-mail address
required field
Congregation Name
Congregation City
Adult Camper for Taste of Camp

Session Registration


First Choice Session Number
required field
First Choice Site
required field
First Choice Dates
required field
Second Choice Session Number
Second Choice Site
Second Choice Dates

Discounts

Please check the box if you qualify for the following discounts... 
Family Discount - $25 per child (sorry, no discount on Taste of Camp sessions)
Early Bird - $40 off if registering before September 30, 2010
Coupon Code

Deposit

Please check the deposit that applies. 
Mini Session Deposit - $50
Full Week Session - $100

Form Submission

By submitting this form my child has permission to take part in all Nebraska Lutheran Outdoor Ministries (NLOM) activities, and I will not hold NLOM or its staff responsible for accidents, claims and damages arising therefrom. I authorize NLOM to take such action as is deemed necessary for the care, welfare and health of my child, including the giving of consent for medical treatment. I also give NLOM permission to use any photographs/video of my child taken at camp in future promotion of any program of NLOM. 
Parent/Guardian Initials
required field
Submit
When you hit the submit button, your registration information will be sent to the NLOM Registrar. You will then be transfered to paypal to pay your registration fee. The registration will not be deemed valid until we have confirmation from paypal that your payment has been received.
required field = Required
 
Connect on Facebook!

 
Nebraska Lutheran Outdoor Ministries

27416 Ranch Road
Ashland, NE  68003

402-944-2544
888-656-6254 (toll free)

 
Quick Links

Image 

Image

Image

Image
 
Image 
 
Read more...