Epworth Camp Meeting
A Place to Love, Grow, and Worship

Camper Registration

If you are interested in attending Epworth Camp Meeting please fill out the application listed below or print a copy to mail in. Also, a medical release form will need to be signed and turned in for each person under 18 years of age. Click here to print the application and medical release form. If you have any problems or questions please contact Harriet Funderburk at (864) 229-6195

Name (First and Last)

Address

City

State

Zip

Date of Birth

Gender:

Female
  Male   

Home Phone Number

Cell Phone Number

Medications Taken Regularly

Date of Last Tetanus Shot

Allergic Reactions

Bee Stings 
  Penicillin   
  Aspirin     
Other   

Any Specific Activities to be
Restricted From

Reason for Restriction

Insurance Information

Policy Number

Address

Web Hosting Companies