Welcome to Sierra Christian Service Camp
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                                College Winter Blast 2012

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                                College and Young Adult Retreat 

                                January 13-16, 2012 (Martin Luther Holliday Weekend).

                                Theme:  "Alpha to Omega"
                                Who can Come?:  Open to all persons, 18 through 30ish.

                                Guest Speaker:  Justin Brock
                                Cost:  $75, or $95 after Jan. 1
                                Time:  Start 5:00 pm, Jan 13th.  End 12:00 PM, Jan 16th.

                                We will have exciting devotions, crazy games, and many surprises!  Hopefully we'll have lots of snow!


                                Links:
                                Release of Liability and rules here.
                                Download the Registration Form here.




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                                Online Registration Available Here!

                                Select Camp Attending
                                Full Name of Camper:
                                Address of Guardians:
                                City:
                                State:
                                Zip:
                                Male or Female: Male
                                Female
                                School Grade entering in the Fall:
                                Birthdate:
                                T-Shirt Size:
                                Parent / Guardian #1 Full Name
                                Male / Female Male
                                Female
                                Home Phone Number:
                                Cell Phone Number:
                                Email Address:
                                Parent / Guardian #2 Full Name
                                Male / Female Male
                                Female
                                Emergency Contact Person:
                                Relationship to Camper:
                                Emergency Phone Number:
                                Church Home
                                Has the Camper attended an event at SCSC before?
                                Has the Camper made a decision to follow Christ?
                                Has the Camper been Baptized?
                                Cabin-mate request(s)
                                Name of guest/returning camper for the "bring a friend" discount:
                                Health Information: Due to health regulations, any special considerations must be in writing. Please list any current medications, allergies to medications, food allergies, special needs, dietary needs, or any concerns which may interfere with the Camper's full participation in events at camp:
                                Signature for Release of Liability: I have read and understand Sierra Christian Service Camp's Rules and Release of Liability (see links above) and electronically write my full name as the parent or guardian of this camper (Parent or Guardians sign for Camper under age 18):
                                Health Insurance Information: Please list name of insurance company, policy number or group number, address, and phone number.
                                Miscellaneous comments or questions:

                                Form provided by Freedback.


                                Sierra Christian Service Camp.  44503 Old Stage Rd.  Posey,  CA.  93260.  Office / Kitchen / First Aid Cabin (661) 536-8555  Residence (661) 536-9323  
                                Email:  SCSCDirector@yahoo.com;  www.sierrachristianservicecamp.org

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