Page 8 - Sugar Creek 2018 Program
P. 8

2018 SUMMER CAMP REGISTRATION FORM… or register online


                  Sugar Creek is an ELCA  2018 SUMMER CAMP REGISTRATION FORM
                  Lutheran affiliated camp.                                                             Photocopy this form if needed
                  First Name  ___________________________ Last _____________________________       FOR OFFICE USE ONLY

                  Address ________________________________________________________________         Code #  _____________
                  City _________________________________  State   _________  Zip  _____________    CC #  _______________
                                                                                                   Cost ________________
                   Boy  Girl  Birthdate  _______________________  Grade Fall ’18 __________
                                                                                                   Dept. _______________
           SUMMER REGISTRATION  Father or Guardian 2  _____________________________________________________  Balance _____________
                  Mother or Guardian 1 _____________________________________________________
                                                                                                   Disc. ________________

                  Phone 1 ______________________________________   Whose? Type of:  _________________________________
                  Phone 2 ______________________________________   Whose? Type of:  _________________________________
                  Phone 3 ______________________________________   Whose? Type of:  _________________________________
                NOT FOR FAMILY EVENTS OR RETREAT REGISTRATION! SEE PAGE 15!
                  Church Name and Town ___________________________________________________________________________

                  In Case of Emergency Phone (above numbers are called first) ________________________________________________
                  Cabinmate Requests* 1 ________________________________  2 _______________________________________
                  *Each camper may mutually request only 2 cabinmates. High School off-site programs are the exception to this policy.
                  Please list the week(s) of camp you would like to attend in order of preference:
                  1st Choice: _______________________  2nd Choice ______________________  3rd Choice  ______________________

                  I AM REGISTERING FOR: (Please check one. If Tiered pricing, please select a tier in the box below)
                   Pilgrims .................................... $225   Confirmation Camp ...........Tiered  TIERED PRICING:
                   Seekers ...................................Tiered   Pedal & Paddle ....................Tiered  Please select the Tier you want to
                                                                                         pay if a price is not specified.
                   Pathfinders ............................Tiered   Jr. Wranglers ........................Tiered
                   Wagoneers ............................Tiered   HANDS ON! .............................$275   Tier 1 ....................................... $499
                   Adventurers ..........................Tiered   Riverboats ..............$480 or Tier 1   Tier 2 ...................................... $450
                   Horse Camp ..........................Tiered   SIT-LIT ..................... $460 or Tier 1   Tier 3 ....................................... $410
                   Discovery Camp .................Tiered   NYG-2-GO ................................$275

                   DISCOVERY ZONE CHOICES (TOP 2): Zone 1 ________________________   Zone 2  _______________________
                  A deposit of at least $100 is required when you register or you may pay in
                  full. Deposits and payments are refundable until June 1, 2018; we retain the
                  deposit after June 1. We do not register by phone. After you register, visit our   MAIL  completed form with at least a
                  website to print the Health Form, Profile Sheet, Camper Letter.            $100 deposit to:
                                                                                        SUGAR CREEK BIBLE CAMP
                  IF YOU REGISTER BY MARCH 15, 2018,
                  YOUR CHILD WILL RECEIVE A FREE T-SHIRT!  T-Shirt Size: _________________   13141 Sugar Creek Bible Camp Rd.
                                                                                   (Youth or Adult?)  Ferryville, WI 54628
                  Credit Card Payment Option: Amount to charge: $___________________    FAX or SCAN with credit card info to:
                  Type of card:  Visa Mastercard Discover                            608-734-3601 or kati@sgrcreek.org
                                                                                        OR REGISTER ON-LINE AT:
                  Card # ______ _______ _______ ______ Exp. Date __________ CV2# _______
                                                                                           www.sugarcreekbiblecamp.org
                  Cardholder's Name (Printed)________________________________________ _

                  Cardholder’s Signature ______________________________________________
                   In addition to my payment, I would like to make a tax-deductible donation of: $________________________ to help other children go to camp.


           8     13141 SUGAR CREEK BIBLE CAMP RD. • FERRYVILLE, WI 54628 • 608-734-3113 • WWW.SUGARCREEKBIBLECAMP.ORG





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