June 12 - 16 2012
Camper, or a head of family ___________________________ phone ___________________
address_____________________________________
city___________________ state____ zip___________e-mail________________________
Church affiliation (optional)_________________________________
check one: Family_____ Single_____
Fee: $80 per camper, 5 and under free, $275 per family cap
circle onecamper____________________________, 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____please do NOT publish photos of this applicant.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 to: (please make checks payable to WCYC)
deposits apply toward your camper fee.
Quest / Jim Frost
156 West Main
Fontana, WI 53125
