FAMILY CAMP  REGISTRATION FORM

Please list only those attending.

Head of Household: _____________________________________
Spouse: ______________________________________________
Address: _____________________________________________
City: ______________________Phone: _____________________
State: _____________________Zip Code: ___________________
E-mail address: ________________________________________

Children's Names                       Age & Grade in fall

1. _____________________    _______________
2. _____________________    _______________
3. _____________________    _______________
4. _____________________    _______________
5. _____________________    _______________
6. _____________________    _______________

Home Church: _____________________________________
Minister: _________________________________________

Accomodations desired: (Camp sites on first come, first served basis)

# in Men's dorm: ____ # in Women's dorm: _____ # in Family Dorm: ____
RV/Camper____     Tent____    Motel Unit/Suite _____
Do you need a site with water & electricity? _____

Other information:
1. Approximate arrival time at camp: ________
2. Approximate departure time from camp: ______________
3. Do you plan to stay for the area wide service? _________________
4. Does anyone in your family have special health requirements? _____
    If yes, how can we help? ________________________________
    ____________________________________________________
    ____________________________________________________

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