Children's Mission Camp Hold Form 2019

Did your church attend Tall Timbers for camp in 2018?*

Yes
No

Church Name / City / State*

Church Name*

Church Billing Address*

Street Address City State ZIP Code

Church Phone*

Church Email (if no email, type none)*

Are you a new contact person for this church?*

Yes
No

Your name:*

Your Cell Phone*

Your Email (if no email, type none)*

Primary Contact*

Your gender:*

Male
Female

Permanent Address*

Street Address City State ZIP Code

Church Employee or Church Contact?*

Church Employee
Church Contact

Your Title:

Date of Birth (to avoid duplicate names in online system)*

Your Email (if no email, type none)*

Primary Cell Phone*

How many spots are you reserving for camp?

You must have 1 adult male per 10 male students and 1 adult female per 10 female students. Your primary adult leader for each gender must be, at minimum, 21 years of age.

Number of male chaperones*

Number of male students*

Number of female chaperones*

Number of female students*

Total People in Your Group:

LODGING

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 if you prefer Lee Lodge.*

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:*

Children’s Mission Camp Hold Form 2019

How many spots are you reserving for camp?

LODGING

Tall Timbers Baptist Conference Center

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