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2014 Mount Calvary Youth Summer Events Registration Form

For all youth who have finished 8


th
grade 12
th
grade
Day at the Dells Saturday, June 21
DEPARTURE: Saturday, June 21 8:30am from Mt Calvary
RETURN: To Mt Calvary 10:30pm
COST: $20.00 (includes upgrade to Theme Park, dinner,
and transportation)
REGISTRATION DUE: Wednesday, June 18
A Liability Release and Emergency Medical Form
will need to be submitted.
Donts forget: Towel, Change of clothes for ride
home, some cover-up to wear in to the park
Lifest: Party with a Purpose July 10-13
DEPARTURE: Thursday, July 10 10:00am from Mt.
Calvary
RETURN: Sunday, July 13 3:00pm to Mt Calvary
COST: $50.00
REGISTRATION DUE: Sunday, July 6 (LAST DAY TO
ORDER TICKETS)
A What to Bring List will be available
A Liability Release and Emergency Medical Form
will need to be submitted
2014 Mount Calvary Youth Summer Events Registration Form
PLEASE PRINT CLEARLY CUT ON THE DASHES AND RETURN TO MOLLY BY THE DUE DATES
Please register me for: (Check all that apply)
Day at the Dells (Include $20.00)
Lifest (Include $50.00)
Students Name _______________________________________ Birthdate _____________ School ___________
Address _____________________________________________ City _____________________ Zip _________
Home Phone (____)_____________ Students Cell (____)_____________ Parent Cell (____)_______________
We, the parents or legal guardians, have also completed and returned the Liability Release and Medical Consent
Form and give permission and support for our son/daughter to attend the event(s) checked above. We authorize
any medical attention needed for our child.
Print Name __________________________ Signature ______________________________ Date __________

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