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Adult Camps Registration 2010

Husband's First Name Last Name

Wife's First Name Last Name (Couples Retreat Registration)

Address and Contact Information Street Address/Box#* City* State* Zip Code*

Home Phone * Emergency Phone Include Area Code in both 

E-Mail   Note: By providing your e-mail address, you are granting permission to Camp Witness to send occasional announcements and communications via e-mail.  These may be related to the specific camp being registered for or general announcements concerning the camp's activities. 

Health Information Health Problems that Camp should know about     

                                                          Allergies    

Church Information

  Churches are alphabetical by City

Home Church  Sponsoring Church

ONLY ENTER the next three field if you were unable to select a church from the list above

Church Name Church City Pastor's Name

Attendance Information Which Camp do you wish to attend?*  

Have you attended Camp Witness before:* Yes No

Camp T-Shirt Options: 

Shirts are sold out for this year.  Sorry

  Payment Method Please contact the camp director if a camp scholarship is needed.

How did you first hear about this year's camping season? 

Any Additional Comments?