RESURRECTION CENTER
 
2007 SUMMER CAMP REGISTRATION FORM
Name of Summer Camp Participant:   
 
First Name: _____________________      Last Name: _________________________
 
 Age: _______________   Date of Birth: __________________    Gender: __________ 
 
By registering my child, I consent to the use of images of the likeness of my child
in Resurrection Center publications and press releases.
 
Parent or Guardian Signature:__________________________________________
 
Address: _____________________________________________________________
 
____________________________________________________________________
 
Phone: (_____)_____________________     Fax: (_____)______________________ 
 
E-mail Address: _______________________________________________________
 
Which 2007 session would you like to attend? 
______  Session    I      AGES  12-13       July      9 - July   12,  2007          $225  
______  Session   II    AGES   8-11       July    16 - July   19,  2007          $225
    
 
Fee includes room, board and all materials.  Financial assistance is available* 
______ $25 down payment (required)                                                                       
                         OR 
______ $225 payment in full (Make check payable to:  Resurrection Center) 
_____ Check here if you are in need of financial assistance*                     
How did you hear about the Summer Program?____Church   ____School   ____Friend 
Please print out and mail the completed online registration form
to    RESURRECTION CENTER Summer Program 
2710 South Country Club Road                       Woodstock,  IL  60098
 
 
MISSION     MINISTRY     SERVICES     FACILITY     HERMITAGE     DIRECTIONS     SUMMER     HOME
 
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Email Resurrection Center         This page updated on 2008.01.23
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Copyright © 2001-2008 by Mary V. Ivers.  All rights reserved.