WCYC Quest registration form   June 15 - 19  2010

Camper, or a head of family___________________________ phone ___________________

address_____________________________________

city___________________ state____ zip___________e-mail________________________

Church affiliation (optional)_________________________________

check one:    Family_____         Single_____

Fee: $65 per camper, 5 and under free, $200 per family cap

circle one
camper____________________________, age (if under 18) ____________ cabin / RV / tent,        $_______

camper____________________________, age (if under 18) ____________ cabin / RV / tent,        $_______

camper____________________________, age (if under 18) ____________ cabin / RV / tent,        $_______

camper____________________________, age (if under 18) ____________ cabin / RV / tent,        $_______

list additional campers on back if necessary
total fee for family - single   $_______

Please list T shirt sizes for attendees:  _______________________________________________________

Camper : "I agree to abide by the rules and policies of Wisconsin Christian Youth Camp"

______________________________camper signature, or a head of family.

By signing this application I authorize Wisconsin Christian Youth Camp to publish photos of this applicant for camp news and promotion unless otherwise indicated with my X below.

____please do NOT publish photos of this applicant.

Camper,Parent or Guardian: "I agree that the camp association is released from any liability in connection with the camper named in this application, except as covered by camper insurance carried by this camp."

___________________________________  Camper or a head of family 18 and older.

____________________________________ Parent/guardian of under 18 campers.

Mail this registration with $25 deposit (for single camper or a family, deposit applies to fee) to:

Quest / Jim Frost
156 West Main
Fontana, WI 53125