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Rental Information |
Facilities |
Food menu |
Snow Blast 2012 Registration
Please fill out the following information for your camper. Starred (*) fields are required.
Camper information
*Camper name:
*Gender:
Male
Female
*Please select Middle School (Grades 6-8) or Sr High (Grades 9-12) Camp:
Middle School (Feb 10-12)
What church are you coming with?
Select One
Bethel Richland
Cheney Faith Center
Indian Trail Church
Fourth Memorial
Garland
His Place PF
Lifecenter
Lifecenter North
Mosaic Fellowship
New Creation Fellowship
New Horizons Community Church
Shiloh Hills
Summit Ridge
Suncrest Family Worship Center
Timberview
Other
Medical information
Please list any medical allergies
Please list any food allergies
(Please note Riverview will not be responsible for ensuring food is allergen free)
Is the camper taking any medications?
Yes
No
If yes, please list all medications.
Is there any other medical information we should know of?
Parent/Guardian information
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
Email:
Home Phone:
Cell Phone:
Work Phone:
Emergency Contact information
The emergency contact needs to be available to pick up the camper at any time, and at their own cost
*Name:
Relation to Camper:
Home Phone:
Cell Phone:
Work Phone:
Release and Arbitration Agreement
I have read and agree to the
Release of Liability
, and agree to it.
