HAMMOND MILL BIBLE CAMP
pre-register by June 15 and receive a FREE camp photo
Please PRINT
I will attend: Childrens_____, Junior____, JR High____, SR Camp ____, (check one)
Boy_______________ Girl_______________ Age_____ Years attended camp_____
Name__________________________Date of Birth_______Grade Entering_____________
Address_____________________________________________
City_________________________________________State__________Zip__________
Home Phone________________________Work Phone___________________________
Emergency Number (other than home or work number)__________________________
Special Medical Needs/Allergies_____________________________________________
Home Church__________________Pastor's Name_________________________
Signature of Parent or Person you live with:__________________________________________
I will ride the bus to camp_____________ from camp______________
I wish to purchase a camp picture for $3.50 _____________
I wish to purchase a camp photo CD ($5) _______________
I wish to give an offering to missions of ________________
I wish to purchase a camp t-shirt ($10) _________________ Size___________________
Registration fee: _________ Less scholarship or church sponsorship______________
Total $_______________ Campers should not bring more than this amount unless they are a Sr. Camper.
Paid _________ Cash ___________ Check number __________ due ___________
Make checks payable to: Hammond Mill Bible Camp
Aurthorization to arrange for and/or consent to emergency medical treatment:
I _____________________________ , am the parent guardian having legal custody of minor child,__________________________. I authorize the Hammond Mill Bible Camp Board to arrange for and or consent to any necessary emergency medical treatment for my child while he / she is under the supervision of the camp as a camper, understanding that I will be notified as soon as possible of any emergency requiring medical treatment.
Dated the _______________ day of ________________, 2008.
Thank you for your intrest in Hammond Mill Bible Camps. Sincerely, the HMBC Board
Please Return Promptly to :
HMBC P.O. Box 1328 West Plains, MO 65775