Camper Registration – Lift the Nations

RiverLife Youth Camp Uganda

Thank you for your interest.
Please email info@liftthenations.org with any inquiries.

Please enable JavaScript in your browser to complete this form.

Camper's Full Name *

Preferred Name to be Called By *

Please enter the name most people know you by and call you by on a regular basis.

Camper's Phone Number *

*If applicable. If no phone, please list phone number of closest contact.

Camper's Date of Birth *

Camper's Current Age *

Camper's Gender *

Camper's T-shirt Size *

Have you attended RiverLife Youth Camp Uganda before? *

Who referred you to camp (how did you hear about us)? *

Do you have any allergies or conditions? If none, please type "none". *

Please indicate environmental allergies or health conditions such as intolerance to cold temperatures, grass, etc.

Do you have any dietary needs? *

Please indicate here if you cannot eat pork, or if you have other serious dietary needs. If none, please type “none”.

Parent/Guardian Name *

Parent/Guardian Contact Phone Number *

I agree to the following charge *

Parent/Guardian Permission & Agreement *

By completing this form and checking the above box, you are giving your permission for the camper listed to take part in RiverLife Youth Camp Uganda.

conditions? Preferred

Please submit a clear photo of camper's face for our sponsors. *

Drag & Drop Files, Choose Files to Upload