Registration Form 2008

2008 CAMP LUTHER REGISTRATION FORM

Name ______________________________
            Last                        First                      Middle
Phone (____)_________________

Address __________________________________________

City__________ State_____ Zip____________

Birthday ______        Sex:       F      M

School Grade as of May 1^st,  2008  _____________
Camp Program    ____Junior (Grades 3-5)   ____ Intermediate (Grades 6-8)    
                                               ____Senior (Grades 9-12)

Is this your first year at Camp Luther?______

Senior e-mail:_____________________

Roommate: __________________________(Person you request must have your name on his/her form for your request to be honored. Only ONE name may be submitted. Juniors and Intermediates only!)

Attention Intermediates: If you would like to be on the camp newspaper staff, check here ____.

Note: Beginner Swimming Lessons will be offered by a qualified instructor as part of the Junior (grades 3-5) class program in the activities rotation schedule. The following will be addressed in the classes: face in water, sideways breathing, floating, front and back crawl, back and breast strokes, treading, and deck diving. Please check if you want your child to take these lessons. If your child is already able to do these activities, please do not check beginner swimming lessons. Beginner swimming lessons ______

Parent's Permission: I support my child’s total participation at Camp Luther. I have enclosed a completed Health form with this registration and the fee of $150.* This camper will stay until the close of Camp. In the event of homesickness or an emergency, I assume full responsibility for transporting my child home before the end of Camp.

Parent’s Signature___________________________

Date____________________________ Phone ____________________

If your church is paying part or all of the tuition, give your registration, health form, and fee to your church. If you are paying the full amount, send completed registration form, health form, and the $150 fee payable to Camp Luther Registrar, 1600 Kanawha Blvd. E., Charleston, WV 25311. The $150 fee MUST BE MAILED with the completed application and health form, or your child will not be registered for camp! If we have to return any uncompleted forms, we will return everything and you will need to complete them and include an additional $10 processing fee for your child to be registered for camp!

TO BE COMPLETED BY PASTOR:

This camper ____is ____ is not a member of the congregation. Our congregation will pay $_____________ toward tuition.

Congregation____________________________ City______________________ State_________ Zip____________

Pastor’s signature:__________________________Date____________ 

Registration deadline: May 1, 2008