Registration Form For Adult only Camp
Camp desired _______________________Camp date ____________________________
Name __________________________________________________________________
Address ________________________________________________________________
City ___________________________________________________________________
Postal Code ____________________ Phone ( ) __________________________
Medical Insurance # _______________________________________________________
Known Allergies __________________________________________________________
Age ___________ Male __________ Female __________
Date of Birth: D: ______ M: ______________ Y: ___________
Home Church ____________________________________________________________
$20
Non-refundable registration fee PER camper enclosed? ____________
Part of camp fee OR Total Camp Fee enclosed? ___________
Registration Time: 2:00 pm Monday
Camp Ends: 2:00 pm Thursday
*NO PETS
Mail to:
COWICHAN RIVER BIBLE CAMP
5070 West Riverbottom Road
Duncan,
B.C. V9L 6J6
Phone (250) 746-7258 Fax (250) 746-7321