2021 StudentLife Registration Form

2021 StudentLife Camp - Estes Park, CO

June 27 - July 3, 2021
Registration Form

$50 Registration Deposit due at the time of sign up.
Student Information
Name:

First Name Last Name
Birth Date:

Month Day Year
Current Grade:
Age:
Are you a Church Member or Sunday School Member of FBCMP?

Yes No
If you are a VISITOR, what church do you usually attend?
Home Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student's Home Number:
Student's Cell Number:
Student's E-mail:
example@example.com
T-Shirt Size (Adult sizes):

Small Medium Large Extra Large 2XL 3XL
Can You SWIM?

Yes No
Level:

Beginner OK Good
Parent Information
Dad's Name:

First Name Last Name
Cell Number:
Email:
example@example.com
Mom's Name:

First Name Last Name
Cell Number:
Email:
example@example.com
PLEASE READ THIS CAREFULLY BEFORE SIGNING AND REGISTERING FOR THE TRIP:

I understand that I am committing to a very important and life changing event. I understand that my $50 registration deposit becomes NON-Refundable on May 17th, and canceling my reservation after June 1st will cost the church an additional $50 in cancellation fees that I will be responsible for paying. If I have to cancel my reservation FOR ANY REASON AFTER JUNE 13th, I will be held accountable for paying ALL expenses already incurred by the church.
Date:

Month Day Year
Date
Student's Signature:

Clear
Parent Signature:

Clear
$50 Registration Deposit due at time of sign up.

Click on this link to pay online:

https://secure.accessacs.com/access/oglogin.aspx?sn=93695
Should be Empty:

2021 StudentLife Camp - Estes Park, CO

Registration Form