Womens Retreat Registration Form

August 15th to August 17th

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First Name: *

Last Name: *

Address: *

City:

Postal Code:

Email: *

Phone: *

Date of Birth (M/D/Y) *

Church Affiliation (If any):

Please add any allergies/dietary restrictions, concerns, or any other important information we should know prior to camp. Thank you for registering!

Comments

How did you hear about camp? *

I undertake and agree to indemnify and hold blameless the Ministry Staff, Pinecrest Baptist Bible Camp and its Camp Board against any loss, damage or injury suffered by the participant as a result of being part of the activities of Pinecrest Baptist Bible Camp, as well as any medical treatment authorized by the supervising individuals representing the camp. This consent and authorization is effective only when participating in or travelling to events of Pinecrest Baptist Bible Camp. *