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Children’s Mission Camp Hold Form 2018
Children's Mission Camp Hold Form 2018
Camp Dates: July 23-26, 2018
Church Name
*
Church Billing Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Parish / County
*
Church Phone
*
Church Email (if no email, type none)
*
Has your church been to Tall Timbers for camp before?
*
Yes
No
Primary Contact
*
Your gender:
*
Male
Female
Permanent Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Parish / County
*
Church Employee or Church Contact?
*
Church Employee
Church Contact
Your Title:
Date of Birth (to avoid duplicate names in online system)
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
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10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
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1972
1971
1970
1969
1968
1967
1966
1965
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1963
1962
1961
1960
1959
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1957
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1953
1952
1951
1950
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1948
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1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Primary Cell Phone
*
Your Email (if no email, type none)
*
How many spots are you reserving for camp?
Number of male chaperones
Number of male students
Number of female chaperones
Number of female students
*You must have 1 adult male per 10 male students and 1 adult female per 10 female students, and you must have 1 adult 21 years or older per gender.
Basic rate is for cabin stay. Lee Lodge hotel rooms are available on a first come, first-served basis for an additional $10 per person.
Choose Yes or No to Lee Lodge preference:
*
Yes
No
Choose from the following:
I would like my entire group (both genders) in Lee Lodge
I would like all of the females in my group in Lee Lodge
I would like all of the males in my group in Lee Lodge
Other scenario
Please explain:
Please choose one security question of your choice for us to set up your online registration and provide the answer below:
*
What is the name of the city in which you were born?
What is the name of the elementary school you attended?
What is your favorite color?
What is your mother's maiden name?
What is your pet's name?
Answer:
*
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