You can register in two ways. Download a registration and mail it in, or register online using the form below.

To register online:

1. Choose your session.

2. Fill out the information below completely. 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 Registration

Camper Information

Camper's First Name

Camper's Last Name

Grade Complete Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Adult

Gender Male Female

Date of Birth

Camper T-shirt size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult XXL

Have you been a camper at CJH before? Yes No

Preference for housing mate

Does the camper have any exceptional needs?
Please explain:

_________________________________________________________________

Parent Information

Parent First Name

Parent Last Name

Address

City, State, Zip

Home Phone

Cell Phone

E-mail address

Congregation Name

Congregation City

Adult Camper for Taste of Camp

__________________________________________________________________

Session Registration

First Choice Session Number

First Choice Site TrailHead Tipi Ranch Springs Whispering Winds Backpacking Sjogren Center

First Choice Dates

Second Choice Session Number

Second Choice Site TrailHead Tipi Ranch Springs Whispering Winds Backpacking Sjogren Center

Second Choice Dates

__________________________________________________________________

Discounts Please check the box if you qualify for the following discounts...

Family Discount - $25 per child when you register more than one child per family (sorry, no discount on Taste of Camp session)

Family Discount

Coupon Code

__________________________________________________________________

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

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.

  Submit Form Preview or Reset