Women's/Men's/Crafting Retreat Registration

GENERAL INFORMATION
Name of Camper:
Address:
City:
State/Province:
Zip:
Phone:
Email:
Home Church:
CAMP INFORMATION
Camp Choice:
Camp Dates:

Food Allergies

First Time Attendee:
Women's Retreat Only

Which Dorm Room Do You Prefer?
Women's Retreat Only

Thursday Night Early Arrival:
Crafting Retreats Only

Listed camper fee:
$
Church Portion
Indicate amount your church agrees to pay camper
$

First Time Attendee Discount
(Applies to Women's Retreat only)

$

Thursday Night Early Arrival Fee
(Applies to Crafting Retreats only)

$

3% PayPal/Credit Card Processing fee:
$
$10.00 Late Registration Fee:
$

TOTAL

$

FOR RETREAT PARTICIPANTS

1) Release of Responsibility: In consideration of the opportunity to participate in the activities, I will not hold Crystal Springs Baptist Camp, its directors, employees, or agents responsible or legally liable for any injuries to the person or property or the results thereof, incurred and suffered as a result of my participation in any of the activities or programs at Crystal Springs Baptist Camp.

2) Willingness to Follow Instructions and Rules: I understand that Crystal Springs Baptist Camp will provide the necessary safety equipment and personnel trained to supervise participation in these activities. I agree to use the equipment as directed and to observe and follow all rules and guidelines for participation in these programs as directed by Crystal Springs Baptist Camp staff. I further agree that any failure to do so on my part may prevent my participation in these activities.

IMPORTANT!

Participant Initial
Retreat participant, please check this box and initial to indicate that you have read, understand, and agree to the previous statements regarding Release of Responsibility and Willingness to Follow Instructions and Rules.
When you submit this form, you may be directed to our payment processing page. If you agreed to make the registration payment online, successful payment processing is required in order to complete the registration process. If you did not agree to pay online, then you can exit the payment process page and payment will be required at a later date. If you have any questions, please email us at office@csbcamp.org or call us at (701) 486-3467. Thank you!