RefugeOC Youth Winter Camp 2022 Registration Form

RefugeOC Youth Winter Camp 2022

January 28th - January 30th, Pinecrest Christian Conference Center
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name *

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact*

First NameLast Name
Relationship to Student *
Date*

MonthDayYear
Phone Number *
Email*
I give permission and consent for RefugeOC Youth to take photos of my youth during camp.

I give permission.
By signing this document, I give permisssion for my youth to attend RefugeOC Youth Ministry Winter Camp 2022 and participate in all activities.
Signature*

Clear
Date*

MonthDayYear
Once this form is submitted you will receive an email with packing and payment information. If you have any questions please contact Pastor Kai or Pastor Jon. We are very excited for Winter Camp 2022!
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