Youth Camp 2008

REGISTRATION FORM

(Please print in ink)

 

Camper’s Name ___________________________________________

Address _________________________________________________

City _______________________   State _______  Zip ____________

Parents’ Names  __________________________________________

Phone  ( ________ ) ________________ q Home   q Cell    q Work

Family’s E-mail address ____________________________________

Home Church ____________________________________________

Church I am coming with (if different) _________________________

q  Male            q  Female                   

Age _____        Grade completed by June _______     

I plan to attend:                                                           

q  Junior I Camp (completed grades 3 or 4)                                  

q  Junior II Camp (completed grades 5 or 6)                        

q  Teen I Camp (completed grades 7, 8 or 9)                            

q  Teen II Camp (completed grades 10, 11 or 12)

Please Note: The camp is determined by the grade completed by June.

I have enclosed:                           

q  Total Camp Fee  (includes non-refundable deposit)

             q $140  Early Camp Fee (before April 1st)

         q $150 Total Camp Fee

         q $160 Late Camp Fee  (after Monday before camp)

or    q  Non-refundable Deposit: $20

         (balance due upon arrival at camp)

q  Family Discount (siblings registering at the same time)

Cabin mate Request __________________________________

(ONE REQUEST ONLY—your choice must request you.)

 

I am attending youth camp for the first time and was invited by:

         ______________________________________________ 

 

Complete the registration form and mail with camp fee to:             

Patti Perry, Camp Peniel Registrar

103 Parkview Ave.

Westerville, OH  43081-2815

 

After June 14th mail to:

              3260 State Route 314

Fredericktown, OH  43019-9413