Camp Registration

YCL Ministries

Camp Registration Information 2011

Instructions:

Fill out a separate camp registration for each child. You can photocopy the form as needed.
If an email address is given, a confirmation letter will be sent to the email address provided within 2-3 weeks of registration receipt.
Payment is due in full with registration unless scholarship is expected.
A $20 fee will be charged for all cancelled or NSF checks.
Requests for refunds or changes to existing registrations must be made in writing 15 prior to the start of the camp. There is a $20 fee each camp cancellation within 15 days prior to the start of the camp.
Registration and payment must be received in the office by the posted date for the early registration rate.

For more information:
Phone: (574)491-3075
Fax: (574)491-2723
Email: info@yclministries.org

Camper First Name:

Camper Last Name:

Address:

City:

Zip:

Birthdate:

Select Date

Gender:

Camper T-Shirt Size:

*We cannot guarantee shirt size

Grade in Fall 2011:

Church:

Parents:

Parents Email Address:

Camper Email Address:

Telephone:

Cellular Phone:

Work phone:

Emergency Contact: If Parent Cannot Be Contacted

Name:

Relationship:

Phone:

Desired Camp:

CIT: June 10-11
Jr. High: June 13-17
2nd-5th Grade: June 20-24
Tadpole: June 23-24
Sr. High: July 11-15
Sibling: July 18-22

Digital Signature:

The child listed above has my permission to attend camp at YCL Ministries and participate in all activities. I also understand that YCL Ministries reserves the right to use photos taken of my child for future promotions unless I submit a written request.