Camp Meeting 2011 Registration

NOTE: Some guests recently encountered problems when registering. Those problems have been fixed. If, however, you encounter a problem submitting the form, you may also register by phone by calling Camp Registrar Randall Crotts at (256) 295-4002.

Please fill out the following form as completely as possible. This information will be sent to the camp registrar, and he will contact you shortly with confirmation of your registration.

*Note: Due to safety concerns, the Camp Board has agreed that there not be shooting of fireworks on the night of July 4. Thank you for your cooperation in leaving all fireworks at home.

Your First and Last Name Your Address City, State, Zip Your Phone # Your Email Address Date of Arrival Select OneMonday, July 4Tuesday, July 5Wednesday, July 6Thursday, July 7Friday, July 8Saturday, July 9Sunday, July 10Monday, July 11Tuesday, July 12 Time of Arrival Date of Departure Select OneMonday, July 4Tuesday, July 5Wednesday, July 6Thursday, July 7Friday, July 8Saturday, July 9Sunday, July 10Monday, July 11Tuesday, July 12 Time of Departure Total Adults Total Children (type "none" for 0) Type of Room Select OneRoom on campground (NOT Heritage Hall)Room in Heritage Hall - 1st FloorRoom in Heritage Hall - 2nd FloorRoom at Chula Vista Church of God facilityCamper/RV Hookup I am bringing an air conditioner. Select OneYesNo Special Needs: (such as elderly, or handicapped, etc.) Other requests or comments: Image Verification Please enter the text from the image: [ Refresh Image ] [ What's This? ] Powered byEMF Web Forms

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