Camp desired _______________________Camp date ____________________________
Name __________________________________________________________________
Address ________________________________________________________________
City ___________________________________________________________________
Postal Code ____________________ Phone ( ) __________________________
Medical Insurance # _______________________________________________________
Home Church ____________________________________________________________
Children - Name and indicate Date of
Birth
M/F D/Month/YR
Please list teens on separate teen registration form.
Type of accommodation desired:
Cabin _______ Tent Space _______ R.V. Space _______ Size____________
$50.00 Cabin reservation deposit (refundable up to 2 weeks prior)
$20
Non-refundable registration fee PER camper enclosed? ____________
Part of camp fee OR Total Camp Fee enclosed? ___________
Registration Time: 2:00 pm Sunday
Camp Ends: 9:00 am Saturday
*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