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If you have already registered and simply need to submit a payment click the button.
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2019 Pacific Northwest DLC
July 14th - 20th
Attendee's Name
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First
Last
Nickname
*
What do your friends call you? This will go on your name tag.
Attendee Phone #
*
Email
*
We will respond to you at this email.
Parent's Name
*
Emergency Contact
*
If your Parent's can't be reach who should we call?
Parent's Phone #
*
Emergency Phone #
*
What number should we use if we can't reach anyone at the contact number?
Mailing Address
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Line 1
Line 2
City
State
Zip Code
Country
Chapter Advisor's Name
*
Advisor's Phone #
*
Food Allergies...
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If you have any food allergies please indicate what they are here.
Select what you are registering as:
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Camper attendee (Youth)
Staff (Adult)
My Jurisdiction
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Washington
Oregon
Idaho
Canada
Other
Birthdate (mm/dd/yyyy)
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Age
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Chapter Name
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Tell us your what Chapter you are from.
Current Office
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Previous Offices Held
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Shirt Size (adult)
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Small
Medium
Large
X Large
XX Large
XXX Large
XXXX Large
Tell us your shirt size.
Have you received your RD?
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Yes
No
Did you receive a Jurisdictional Scholarship?
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None
$100
$200
$300
Highest LCC Completed
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Lesson 1
Lesson 2
Lesson 3
Lesson 4
Lesson 5
Have you been to DLC before?
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No
Once
Twice
Three or more times
Medical History:
Please download a copy of the Medical Release / Parental Consent and fill it out completely. Once you have your form complete and signed by both the attendee and his parents/guardian you will need to scan it and attach it here. You will not be able to register for DLC without it. If you have questions about this feel free to contact us.
Upload Your Medical Release / Parental Consent
*
Max file size: 20MB
Click Here to Download a
Medical Release/
Parental Consent Form
Payment info:
Once you submit your registration you will be given two payment options to pay your balance owed. Please indicate if you are submitting an electronic payment or a check in the mail.
Choose One
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Electronic Payment thru PayPal
Check by mail
Other (indicate in comment field the details)
Comment
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By clicking submit registration you understand that you must comply with all rules of the conference or you will be subject to immediate removal at your own expense without a refund.
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I understand.
Submit Registration for Processing and Take me to Payments
Home
2018 Camp
Prev Camps
2017 Camp
2016 Camp
Notebook (2016)
About
Contact
Online Payment
Registration
DLC Staff
FAQ
