Registration Form | Prairie Lakes Distri

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Prairie Lakes District Assembly & Family Camp

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Making Tea in Nature

Family Camp and
District Assembly Registration

First Name

Last Name

Street Address

City

Region/State/Province

Postal / Zip code

Email

Phone

# of adults

# of children 0-3 yrs

# of children 4 yrs through 1st grade

# of children 2nd through 6th grade

# of children 7th through 12th grade

If you are registering for someone else named above, please put your name and phone number here

If you're connected to a local church on the Prairie Lakes District, please list it here

Volunteers: please indicate your role

©2025 by Prairie Lakes District Family Camp

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