Thanks for submitting your application! You will receive an email confirmation shortly with a copy of your form.
Central Registry Clearance
Michigan residents over 21, please print this form form and follow directions below.
Indiana residents, please use this form and follow directions below.
Illinois residents, please use this form.
Iowa residents, please use this form.
Wisconsin residents, please contact David Kenyon, Camp Coordinator.
All other states, please check here.
*Note: if you filled out this form last year, or have been at Camp Lor-Ray consistently since filling out this form, without any lapse in years, you do not need to do so again.
Specific Instructions for Michigan Residents
(A number of questions have arisen over section 2. Please check Camp Lor-Ray as an “Employer.” As an “Employer,” you do not need to fill out the box titled “Name of CPS/Law Enforcement or Court.”)
Dept. Health and Human Services
Bureau of Children and Adult Licensing
Attn: Kim Garza
7109 West Saginaw Highway
Lansing, MI 48917
Return address at bottom of DHS form must be:
P.O. Box 357
Twin Lake, MI 49457
[Michigan.gov map of county offices]
Specific Instructions for Indiana Residents:
Indiana Department of Child Services, COBCU
302 W Washington St.
Room E306, MS08
Indianapolis, IN 46204
Scan and email form to: email@example.com
Fax to: 317-234-4633
Specific Instructions for Illinois Residents:
At the bottom of the page the form requests information about the submitting agency. The submitting agency is Lor-Ray Camp Association.
Specific Instructions for Wisconsin Residents:
Contact David Kenyon