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REGISTRATION FORM Father/Son Retreat 2010 (Please print in ink) Father’s Name ____________________________________________ Address _________________________________________________ City _____________________ State _______ Zip ______________ Phone ( _______ ) _______________ q Home q Cell Phone ( _______ ) _______________ q Home q Cell E-mail address ___________________________________________ Home Church ____________________________________________ Son’s Name _______________________ Age/Grade ___ / ___ Son’s Name _______________________ Age/Grade ___ / ___ Son’s Name _______________________ Age/Grade ___ / ___ Son’s Name _______________________ Age/Grade ___ / ___ Son’s Name _______________________ Age/Grade ___ / ___ Accommodations desired: q Cabin q Campsite for tent or trailer Fee applied: q Early (before March 1) q Standard q Late (after April 16) I have enclosed: q $10 Deposit (Balance of camp fee due upon arrival at camp) q Entire camp fee of $_____________
Please complete the registration form and mail with camp fee to: Patti Perry, Camp Peniel Registrar 103 Parkview Avenue Westerville, OH 43081-2815 * Make all checks payable to Peniel Bible Camp. * $10 deposit is non-refundable and non-transferable. * Returned checks are subject to a $20 charge. * Registrations cannot be accepted by phone or email. * Registrations will not be confirmed until registration form and money are received by the Camp Peniel Registrar. |