2008 Single Parent Family Camp

(June 22nd - 27th)

 Registration:

Please print this form, fill it out, then mail to:

Burke Brack/Singles Minister; 3500 Golf Course Road; Midland, TX; 79703

 

If you have questions, please call 432-694-8836 and visit with either       Burke Brack (Singles Minister) or 

Cathy Aduddell (Singles Ministry Assistant)

Please feel free to email us too. 

Burke@gcrcc.org   or   Cathy@gcrcc.org

(please print)

 

Parent's Information

 

First name                                        Last Name                                             

 

M / F (please circle)  Please indicate which size SPFC 2008 t-shirt you would like.               

 

Street Address                                                                                                      

 

City                                     State                Zip                     

 

Contact Phone (      )                   Email                                                              

 

Payment Information

(Cost per camper is $100.00)  Deposit is $100.00 but will applied towards one member of the family.  The deposit is non-refundable.

 

Sending deposit only           Paying in full             

 

Cash         Check         check #            

 

I am…

 

        divorced             widowed               never married

 

        custodial parent          my children do not live with me

 

Child Information:

(For kids entering grades pre-K through teens who have just completed their senior year of HS)

 

First name                                         Last Name                                     

 

M / F (circle)   Age          Grade (08-09 school year)                            T-shrit size: _____

 

First name                                         Last Name                                     

 

M / F (circle)   Age           Grade (08-09 school year)                       T-shrit size: _____

 

First name                                         Last Name                                     

 

M / F (circle)   Age          Grade (08-09 school year)                       T-shrit size: _____

 

First name                                         Last Name                                     

 

M / F (circle)   Age           Grade (08-09 school year)                       T-shrit size: _____

 

First name                                         Last Name                                     

 

M / F (circle)   Age          Grade (07-08 school year)                       T-shrit size: _____