Registration Form


Name: ___________________________________________ Event Attending: _________________________

Address: _________________________________________ Date of Event: ____________________________

City/St./Zip: ________________________________________________ Bunk Preference: Upper _____ Lower _____

Male: _____ Female: _____ Age: _____ Cabin Partner: _________________________________________________

Grade this Fall: _____ Immersed Believer: Yes _____ No _____

Parent: ____________________________________________ Email: ___________________________________

Day Phone: _______________ Night: ________________ Cell: ____________________  

Camper's Home Church: __________________________________________


 



 


 
 

 
 
 
 

 

Office Use
 Cabin:_____ Bunk:_____Group:_____

Office Use
 Here:_____Not Here:_____

Sponsoring Church Use
Church:___________________________ will pay $_________ of Camper's fee. Signed:________________________

Office Use Only

Camper Paid in Full:_________                                                            Church Paid in Full:__________

Camper Amt. Due: $_________                                                            Church Amt. Due: $__________

Amt. Paid: $_______________     Date: ___________                            Amt: Paid: $_________ Date: _____________

Balance: $_________________                                                            Balance: $__________________
Camper Check Out
SICSC is committed to making your child's stay here as pleasant as possible and we want you to have a peace of mind that we are doing all we can to make it a safe stay.  We have a check out procedure where you will need to sign out your child before leaving the camp grounds at any time.  You should check out your child at the camp office before leaving.  We hope you will not look at this as just another inconvenience but a procedure set in place for the protection of your child.  Please fill out these forms and bring them with you on registration day.   

Camper's Name:________________________________________

Parent's Name:_________________________________________

Who will pick the camper up at the end of camp_____________________________________________

Do you plan on picking your child up early on closing day?   No_____     Yes_____   Time__________

Do you plan on taking your child off camp grounds any time during the week?  No_____    Yes_____

          Date:__________  Time Leaving:__________ Return Time:__________

          Date:__________  Time Leaving:__________ Return Time:__________