Name____________________________________________________________________
Address__________________________________________________________________
City_________________________________________________ Zip_________________
Phone(s):_________________________________________________________________
email:____________________________________________________________________
Have you attended any
previous Lake Aurora events? Yes or No
Community Service Project 8am-5 pm Friday?
Yes or No
Home Church:______________________________________________________________
City:_____________________________________________________________________
Cost : $65 if
staying on campus, $60 if staying off campus
Part time guests: $30 for Friday only, $35 for Saturday
only
Extra Community Service Project: $10
Please add a 3% surcharge when
using a corporate account credit card.
Amount to be charged: _________
Mastercard
Visa
CC
#____________________________________________________________exp______
Last 3 digits located on back of card________________
Name on
card:_____________________________________________________________
Authorized
Signature:_______________________________________________________
Billing address of
cardholder:_________________________________________________
City:___________________________________ST:___________Zip:_______________
Phone of card holder:
_____________________________________________________
HOUSING - 250 beds are available for this retreat. Please state if your lodging will not be on campus.
I will be staying in: (Please circle)
Dorm Motel ____Other ____I am physically UNABLE to sleep on a top bunk.
Submit this form and fee to the camp office.
Fax 863.696.1062 (Credit card payments)
A Confirmation ticket will be mailed to you if received before 3/1/08.