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FOR OFFICE USE
ONLY: PC# $ / CC#
$ / SWC $ DATE: |
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2008 CAMP
REGISTRATION FORM
Southwest
Conference United Church of Christ |
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Camper’s Name: |
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Parent/Guardian |
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Mailing Address: |
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Names: |
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City: |
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Best Contact Info:
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State: |
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Zip: |
Home Phone(s) |
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Birth date: |
/ / |
£
Male £
Female |
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Grade entering
(Fall ’08) |
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Work Phone(s) |
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Home Church: |
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Prefers to be
called: |
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Cell Phone(s) |
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Home phone: |
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Cell phone: |
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Parent’s Email(s) |
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E-mail: |
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T-shirt size: |
Youth:
£
Med. £
Lg. Adult:
£ Sm.
£Med.
£Lg.
£1X
£
2X |
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Camp for which you
are registering: £
Young Juniors (6/15-18,
2nd-3rd grd)
£
Juniors (
6/15-20, 4th-6th grd)
£
Junior High
(6/15-20,
7th-9th
grd)
£
Sr. High
(6/29-7/5, 9th-graduate)
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Have you
previously attended camp a Southwest Conference camp?
£
No
£Yes,
for ________yrs. |
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CAMP FEES: |
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REGISTRATION
FEES: |
Young Junior
Camp:
4 days
$160
(Early discount before April 30: $150)
Junior & Junior
High Camps
: 6 days
$330
(Early
discount before April 30: $300)
Senior High Camp:
7
days
$350 (Early
discount before April 30: $315)
Final
Registration Deadline for ALL CAMPS is MAY 15
YOUR
FULL CAMP FEE: $_________ |
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TRANSPORTATION: |
ARRIVING
at camp
by:
£
Camp bus from Phx ($25)
£
Car
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LEAVING
camp
by:
£
Camp bus to Phx ($25)
£
Car
(Bus round trip
$50) +$ _________ |
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AIRPLANE
INFO:
£
Need
transport from Airport to bus
£
Need
transport from bus to Airport
Airport arrival
date: ___________ Time:___________ Airline_____________
Flight______
Airport departure
date:_________ Time:___________ Airline______________
Flight______ |
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TRAVEL POOL
Assistance:
£
I would
like travel pool assistance and will submit an airline
receipt for
mileage to the Southwest Conference Office following camp to be
reimbursed
(Available to New Mexico and Texas
campers) |
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CAMPERSHIP
Assistance:
£
I have
applied for a SW Conference Campership and have
attached that
form. Financial Assistance from SW Conf: --$_________ |
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Financial Assistance from my church
--$_________ |
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(Please make your
check payable to your local church)
TOTAL CAMPER
PAYMENT: $_________
(If you are not
registering through a local UCC church, please see instructions on
page 4 of the Camp Brochure) |
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The undersigned
people have read the camp guidelines (located on pgs 5-8 of the
brochure) for participating at camp and agree to abide by those
guidelines. We also understand the Southwest Conference uses PHOTOS
of campers in brochures, newsletters, and publicity
materials. (£
Please DO NOT use photos of my son/daughter) |
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Signature of
Pastor: |
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Signature of
Camper: |
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Signature of
Parent: |
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