COST OF THE CAMP
The total tuition is $70.00. Enroll by May 1st and receive a $10.00 discount
Option 1: r enclosed is the total tuition of $80.00 ($70.00 if received by May 1 st)
Option 2: r enclosed is $25.00 deposit. I will pay $55.00 upon arrival at camp. (Early discount does not apply.)
Deposits paid are non-refundable after June 1, 2005. Each year, we fill up. We cannot hold your place unless a deposit is
Paid.
A top quality new “2005” T-shirt has been designed just for our camp session. You must purchase it by May 1.
r Enclosed is an extra $10.00 for my exclusive T-shirt. Indicate size (circle one ) S M L XL XXL
Total enclosed $__________________
Optional canteen (snack bar) cards are available at $10.00 each. Most kids need one or two cards. These should be
purchased at registration time on Sunday .
REGISTRATION TIME: 2:00 – 4:00 p.m., Sunday, June 19, 2005.
Clip the application and mail it now! We have room for only a limited number of campers. NOTE: When camp is full, applications will be
Put on a standby list. Rules for acceptance and participation in the program are the same for everyone without regard to race, color, sex,
age, handicap, religion, or national origin.
Mail Completed Application to:
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Child’s Name_____________________________________ Email _____________________ Address _________________________________________ City _______________________ State _________________ Zip Code _____ Church Affiliation __________________________________ Parent’s Name _____________________________________ Phone Day ______________________ Night ___________________ Parent’s Address ________________________________
I agree to abide by camp rules and regulations (Camper’s Name) _________________________ I, the undersigned Parent or Guardian, hereby give permission for the above named child to attend Lake Cisco Christian Camp. I authorize the Camp Director to enforce Camp rules. It is our policy to contact the parent of any child (under 18 years old) who wishes to be baptized.
Signed __________________________________________________________Parent or Guardian
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LAKE CISCO CHRISTIAN CAMP
c/o Cisco Church of Christ
P. O. Box 629
Cisco, Texas 76437
(254) 442-1450 fax: (254) 442-2499
email: ciscococ@sbcglobal.net
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LAKE CISCO CHRISTIAN CAMP HEALTH CARD (Please Print) Camper’s Name _______________________________________________________________________________________ Birthday: Month_______________Day ____Year______Last school grade completed_____ SEX__M___F ALLERGIES: Yes______No_____If yes, list________________________________________________________________ IMMUNIZATIONS: Diphtheria Tetanus:____Yes___No Polio:___Yes___No Smallpox:___Yes___No Others Please list;________________________________________________________________________________ List medications (prescription and non-prescription) currently being taken__________________________________________ ______________________________________________________________Please send written instructions with medications List any existing medical or psychological/psychotic conditions__________________________________________________ CHILD’S PHYSICIAN’S NAME_____________________________________________PHONE NO.__________________ Any medications should be sent in the labeled prescription bottle or original package. Please send any additional medical Information on a separate piece of paper. I, the parent or guardian of the above named child, gives my authorization for emergency medical care if the need arises. SIGNATURE OF PARENT OR GUARDIAN_______________________________________________________________ EMERGENCY CONTACT PHONE NUMBERS_____________________________________________________________ The parent or guardian of every child attending camp must complete this card.
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