2023 White Out Retreat Registration

2023 White Out Retreat Registration
December 28 - 30, 2023

7th grade through College Age Campers
Camper First Name*
Camper Last Name*
Birth Date*

MonthDayYear
Date
Age*
Grade in the fall*
Sex*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email*
example@example.com
Camper Email
example@example.com
Other family members attending camp?
New Camper
Have you ever been a camper at Twin Peaks Bible Camp?
As a camper, I agree to obey all camp rules.*
Parent or Guardian Information*

First NameLast Name
Relation to camper*
Parent or Guardian Address - if different from camp address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Email
example@example.com
Alternate Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please give the name(s)and relation of anyone who should NOT pick up your child from camp. Please provide current custody papers to verify.
Please give us the name, address, and phone number of anyone you have given permission to pick up your child at camp, if you are unable to do so.
I give permission for Twin Peaks Bible Camp to use any pictures taken of my camper at camp on any promotional material or the camp website.*
Signature*

Clear
Date*

MonthDayYear
Date
Payment
prevnext( X )
Camp Fee
This is the early registration fee for Winter Teen Camp. The cost will be $100 after December 1, 2022.

$100.00

Total

$0.00
Should be Empty:

2023 White Out Retreat Registration

December 28 - 30, 2023