Youth Registration at Pleasant Valley Christian Camp 2001

Puget Sound Christian Service Camp

E-mail:
PLEASANT VALLEY CHRISTIAN CAMP

P.O. Box 175 Mineral, WA 98355
1-800-789-9841

2001 Pleasant Valley Youth Camp Registration Form
Registration is not COMPLETE until we have received your deposit AND the consent form.

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Information from the form on this page will be sent directly to PVCC. However, it must be matched with the consent form received by postal mail shortly thereafter. The Parent/Guardian Application and Consent Form must be printed out, filled out, signed, and received by PVCC (along with your check) before camp starts. Please use one form for EACH child. Bed space is limited. Register early to avoid disappointment.

Camper's Name: Boy Girl

Head of Household:

E-mail:

Address:

City:

State:

Zip:

Phone:

Camper's Age:

Birthdate:

Grade Next Year:

Church:

Minister's Name:

Note: You may take a $10.00 ($5.00 for First Chance Camp)
Discount if your fee is PAID IN FULL 2 weeks prior to camp.

I am sending $ for the camp indicated below.

If your church is paying part of your camp fees, indicate the amount here:
$

I am registering for the following YOUTH camp:

First Chance Camp (July 5-7), $55

First Jr. High Camp (July 22-28), $170

First Junior Camp (June 24-June 30), $170

Second Jr. High Camp (Aug. 19-25), $170

Second Junior Camp (July 8-14), $170

First Senior High Camp (July 15-21), $170

Third Junior Camp (Aug. 5-11), $170

Second Senior High Camp (Aug. 12-18), $170

Parent/Guardian of Camper: REMEMBER! The CONSENT FORM must be received in order for application to be considered complete.

Did you fill out the Consent Form?

T-shirts, denim shirts, and other clothing items on sale all summer in the canteen!

Mail completed form and fees to:
Pleasant Valley Registrar
c/o Shoreline Christian Church
14800 First Ave. N.E., Shoreline, WA 98155
1-800-789-9841 • Fax: 206-364-3288
E-mail: pvccpam@juno.com
Or register online: www.pleasantvalleycamp.org