|
REGISTRATION FORM Mother/Daughter Retreat 2012 (Please print in ink) Mother’s Name ______________________________________________________ Address _______________________________________________________________ City _________________________ State _________ Zip ____________________ Phone ( ______ ) _______________ q Home q Cell q Work Phone ( ______ ) _______________ q Home q Cell q Work Email address ________________________________________________________ Home Church _________________________________________________________ Daughter’s Name Age / Grade Completed ____________________________________ ________ / ________ ____________________________________ ________ / ________ ____________________________________ ________ / ________ ____________________________________ ________ / ________ ____________________________________ ________ / ________ Accommodations desired: q Cabin q Campsite for tent or trailer Fee applied: q Early (received before April 1) q Standard q Late (received after June 22) I have enclosed: q $20 Deposit (Balance of camp fee due upon arrival at camp) q Entire camp fee of $_____________
* Make all checks payable to Peniel Bible Camp. * $20 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.
Please complete the registration form and mail with camp fee to:
Patti Perry, Camp Peniel Registrar
|
