2011 Family Camps Registration Form

Please fill out, print, and mail this form with your payment 2 weeks in advance. Bed space is limited. Register early to avoid disappointment.

Memorial Day Work Camp Fee: $15.00 per person
Family Camp Registration Fee: $10.00 Registration Deposit per family.   Cost Calculator
Senior Camp Registration: Freewill offering at camp to cover costs.
Men's Retreat Fee: $55

Check which camp you are registering for:

Memorial Day Work WeekendMay 27 - 30

Family CampJuly 24 - 30

Senior Saints CampSept. 8 - 10

  Men's RetreatSeptember 16 - 17

Please list names of all adults in your family who will be attending camp (Family Camps only):

Adults's Name: Adults's Name:

Please list names and ages of all children in your family who will be attending camp (Family Camps only):

Child's Name: Grade:
Child's Name: Grade:
Child's Name: Grade:
Child's Name: Grade:
Child's Name: Grade:

Head of Household:

Address: City:

State: Zip:

Phone:

E-mail:

Church:

Minister's Name:

I am sending $ for the camp indicated below.

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

Family's Medical Insurance Company (Family Camps Only):

Work Phone:

Alternate/Emergency Phone: ___________________________________________

Arrival Time: Day:

Departure Time: Day:

Your accommodation preference: RV   (Size)     Cabin Tent

Men & Senior Saints: Do you plan on eating your meals in the camp dining hall?
Yes   No

NOTE: There is a "No Dog" Policy for all camps.
Please make other arrangements for your dog.

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

Mail completed forms and fees to:
Pleasant Valley Registrar
PO Box 175
Mineral, WA 98355
                   1-800-789-9841           1-800-789-9841
E-mail: Dan Hamilton