Youth Camp 2026

June 8-12, 2026 | Please fill out this form and click submit.

For more information on Camp Refuge please visit: http://www.camprefuge.org/about.html

Grant Ripperger will be sending out updates through the parent email that is provided on this form.

*Registration: $400

*May 31 - Registration Deadline*

*May 31 - Mandatory Parent Meeting @ Westland Chapel 12:30PM-1:00 pm*

Please also complete the Latham Springs Registration for each student that is attending

CLICK HERE TO REGISTER

Student Name

Parent Email

This address will receive a confirmation email

Address

Parent Phone

Student Date of Birth

Shirt Size

Please select one option.

S M L XL XXL

Grade Completing

Please select one option.

12th 11th 10th 9th 8th 7th 6th

Name of School

Emergency Contact

Emergency Contact Number

Allergies

Medications you are currently taking:* Regarding medication, every person bringing medication to camp will need to include a signed Medication Form in a Ziploc bag with their medications. **Forms will be available at the parent meeting, May 31st.

Name of Insurance

Insurance Phone Number

Policy/Group/ID Number

If you are in need of sponsorship assistance, please select the sponsor payment option when registering and reach out to Grant Ripperger directly to discuss next steps.

Grant Ripperger's Contact Information:

Email: grant@westland.cc
Phone: 281-925-8475

Payment

Full Price ($400) Sponsor ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

June 8-12, 2026

Please fill out this form and click submit.

For more information on Camp Refuge please visit: http://www.camprefuge.org/about.html

Grant Ripperger will be sending out updates through the parent email that is provided on this form.

Youth Camp 2026

Description

Please Fix the Following