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Twin Peaks Bible
Camp
Winter Retreat
(Junior High, High School & College
age)
Registration Form
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| Camp is located 7 miles south of Collbran, CO. In
Collbran follow the signs to Grand Mesa & Bonham
Reservoir. |
| (please print this form, fill it out and send
it to the address listed below) |
Name |
Phone |
Age______ |
Sex....M...F |
Address____________________________ |
City________________ |
State |
Zip |
Parent or Guardian |
Phone |
| Address |
City |
State |
Zip |
| Place of Employment |
Phone |
| Doctor's Name |
Phone |
| In case of emergency, I understand
that every effort will be made to contact me. In the
event that I cannot be reached, I hereby give my permission
to the physician selected by the camp director to heospitalize
and secure proper treatment for my teen (includeing
surgery). If I cannot be reached you may contact the
following: |
| Name |
Relationship |
Phone |
| |
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| Signature: |
Date |
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| Please return to: Twin Peaks Bible
Camp P.O. Box 907 Grand Junction, CO 81502-0907 (970)
434-8308 |
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