|
Mother/Daughter Retreat 2010 REGISTRATION FORM (Please print in ink)
Mother’s Name ______________________________________________ Address ____________________________________________________ City _______________________ State _______ Zip _______________ Phone ( _______ ) _______________ q Home q Cell Phone ( _______ ) _______________ q Home q Cell E-mail address ______________________________________________ Home Church _______________________________________________ Daughter’s Name Age / Grade Completed ________________________________ ______ / ______ ________________________________ ______ / ______ ________________________________ ______ / ______ ________________________________ ______ / ______ ________________________________ ______ / ______ Accommodations desired: q Cabin q Campsite for tent or trailer q Drive-in Fee applied: q Early (before April 1) q Standard q Late (after June 25) 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
(Address until 6/24) 103 Parkview Ave Westerville OH 43081
(Address after 6/24) 3260 State Route 314 Fredericktown, OH 43019 * 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 Registrar. |