Application for Ladies Retreat
September 10th - 12th, 2021
Applicant's Personal Information
Last Name: *
First Name: *
Address: *
City: *
State: *
Zip Code *
Primary Phone Number (Include Area Code) *
Secondary Phone Number (Include Area Code)
Email Address: *
Emergency Contact Person *
Their Primary Phone Number (Include Area Code) *
Is this your first time attending Yellowstone Bible Camp? *
Choose the nights you plan on spending at YBC *
Required
Special Situations: Please check all that apply. *
Required
OTHER MEMBERS OF YOUR PARTY? If other person(s) are attending camp with you but are not members of your immediate family (defined as dad, mom, and your own children) please submit a separate application with appropriate fees. Minors’ applications MUST bear signatures of their own parents/guardians.
Camper's Acknowledgement of Risk
I recognize that there is an element of risk in any adventure, sport, or activity - especially those associated with the outdoors. I assume full responsibility for myself, my family, and any minor child(ren) not my own but attending camp with me, for bodily injury, death, and loss of personal property and expense thereof, except to the extent such damage or injury may be due to the negligence of YBC. I have fully read the Standards of Conduct and policies located in the YBC Newsletter or YBC web-site, and we will comply with all standards and policies. I have read, understand and accept the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon the parties during the period of attendance at Yellowstone Bible Camp. In addition, my signature agrees and grants full right to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the aims of Yellowstone Bible Camp. This might include (but is not limited to), the right to use them in their printed material and online publicity, social media, press releases and funding applications.
Electronic Signature
Signature is required
Head of Household *
Today's Date *
MM
/
DD
/
YYYY
Yellowstone Bible Camp does not discriminate as to color, creed, or nationality in accepting applications.
After you hit the submit button below you will have completed Step-1 and will be taken to a page where you will complete Step-2. To avoid double entries only click the Submit button one time and do not use your browser buttons for any reason. Step-2 includes checking out and paying for your reservation. If for any reason you do not complete Step-2 your registration will be discarded and you will be required to start the process from the beginning by filling out the application again. Thanks for choosing Yellowstone Bible Camp!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy