Registration form

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Beach Camp 2018 Registration form July 22 - 28, 2018 at Emma Wood State Beach $299 on June 10, $349 starting on June 11 Registration ends on July 8 Student’s Name: Parent’s Name:

Parent Information Mailing Address:

Parent’s primary contact phone number:

___ Home ___ Cell

Email address where you would like to receive notifications and updates:

Student Information Grade student will enter in 2018 / 19 school year:

Student’s shirt size:

Tent mate Requests:

Does your student wish to be baptized?

Yes

Considering Baptism

Any Special Instructions Regarding this camp (i.e. Picking your child up early, dropping off late, etc.)?

I will review all the information I receive when I register my student. I recognize that I am responsible for reading it and knowing the information. I recognize that I am financially responsible for my student’s camp fee. I will help to make sure that my student adheres to the rules of the camp. Parent Signature: For Office Use: Amount Paid: Date: __________________

_____ Cash

_____ Check #____________

Initial : Initial

Additional Payments:

Notes: