NBI Visitor Form

1

Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Area Code

Phone Number

3

E-mail* This field is required.

4

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

5

Are you currently at least 18 years old?* This field is required.

YESNO

6

I am the invited guest of:* This field is required.

First Name

Last Name

Their Title/Position

7

Purpose of your visit.* This field is required.Please write a brief description of why you are visiting NBI.

8

I plan to arrive on:* This field is required.

Date

Hour

Minutes

9

I plan to depart on:* This field is required.

Date

Hour

Minutes

10

Will you be eating camp meals?* This field is required.($5.00 for each meal)

YESNO

11

I would like to attend the following meals and will pay $5.00 for each meal (due at check-in):

Breakfast (only offered Saturday and Sunday)

Lunch

Dinner

12

Please select any allergies that apply to you or those who are in your care that will be visiting with you:NOTICE: We only provide food alternatives for the allergies listed below.

None

Gluten

Celiac

Dairy

13

If available, I would like to stay in Silver Birch Ranch housing during my stay for the cost of $10 per person per night:* This field is required.

YESNO

14

Will you be staying with someone off camp grounds?* This field is required.(e.g. A staff member)

YESNO

15

Who will you be staying with?

First Name

Last Name

16

Visitor Release Form* This field is required.Silver Birch Ranch is committed to the safety and well-being of everyone who is involved in any aspect of our ministry. From time to time events may occur where medical care or treatment is necessary for an individual while they are involved in this ministry.

17

Emergency Contact* This field is required.

First Name

Last Name

18

Emergency Contact Phone Number* This field is required.

Area Code

Phone Number

19

List family members and/or those in your care who will be staying with you (if applicable):NOTE: If family a member is 18 or older, they must fill out this form separately.

Full name

Relationship

Full name

Relationship

Full name

Relationship

Full name

Relationship

20

Please Download PDF, fill it out, and be ready to hand in when you arrive at Nicolet Bible InstitutePlease download

21

Have you read and agreed to the visitor guide?* This field is required.

22

Digital Signature* This field is required.

First Name

Last Name