"Today is the Day"
to sign up for Summer Camp

Estimated Arrival Time

Estimated Departure Time

Dates Requested : (mm/dd/yyyy)
/ /
thru
/ /

Church/Group Name

Church Phone Number:
( ) -

Address (Street, City, State, Zip)

Contact Person:

Home Phone Number:
( ) -

Work Phone Number:
( ) -

Cell Phone Number:
( ) -

Fax Phone Number:
( ) -

E-mail address:

Total Number of People (estimated):

Male

Female

Age:
Children

Youth

Adult

Type of Retreat: (marriage, teen discipleship, deacons, choir, kids camp, etc.):

Sleeping preference:

Heated Cabins

Non-Heated Cabins

Meals (check):

Breakfast Lunch Dinner

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Programs you are interested in using:

Other requests: