YOUNG ADULT CAMP 2012

ONLINE REGO

Full Name
Date of Birth
Mailing Address
Mobile
Email
Name of Emergency Contact
Number of Emergency Contact

When will you arrive at camp?		Fri night by 9pm Fri night after Youth Group Sat before breakfast (by 9am) Sat before lunch (by 1pm) Sat before dinner (by 7pm) Other

Will you be riding the bus to/from LCC?		Yes No

What is something that not many people know about you (so we can use it for a Quiz)?

Allergies/Dietary Requirements

Any further questions or comments:

Payment Method:		1. Cash 2. EFT 3. Credit Card 4. Cheque 5. Other

		PAYMENT INSTRUCTIONS: 1. CASH: Please give cash to Emily or the LCC office 2. EFT: Make an Electronic Funds Transfer (EFT) into the Lifestreams Christian Church, South Perth \| All rights reserved General Fund BSB 036 037 ACC 152766 Please mark the transaction as YA and your name (EG. YA Bobby Smith). Then email Emily at emily.dickinson@lifestreamscc.com to let her know you've sent the money through. 3. CREDIT CARD: If you want to use a credit card please ring Emily on 9313 1600 4. CHEQUES: Make cheques payable to Lifestreams Christian Church, South Perth \| All rights reserved 5. OTHER: If you ticked OTHER you will need to speak to Emily

Submit Registration

Any queries please don't hesitate to call on 9313 1600 or email Emily.