Children's Retreat - South Mountain Baptist Camp

Church Information

Church Name*

Church Phone*

Contact Name*

Email*

Would you like to to receive the registration packet by e-mail or postal mail?*

E-mail only
Mail to the church
Mail to my address

Church Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Information

Contact Phone

Contact Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Retreat

Which retreat would you like to reserve?

October 11-12, 2024
October 18-19, 2024

If your preferred date is full, would you like to reserve the other weekend, if available?

Yes
No

Camper Information

Number of campers attending

*Note: Chaperones are required at a ratio of 1 adult per 6 campers. Coed groups REQUIRE coed chaperones.

Female Campers*

Female Chaperones*

Male Campers*

Male Chaperones*

Total*

Deposit Information

A deposit of $30 is required for each person (campers & chaperones) to confirm your reservation by May 16, 2024.
This deposit is NOT refundable under ANY circumstance.
One deposit is applied to each camper fee, extra deposits may NOT be applied to a group's balance.
Deposits may be made with check or money order payable to:

South Mountain Baptist Camp
3558 Baptist Camp Rd
Connelly Springs, NC 28612 The total fee for this retreat is $85. The balance of $55 per camper will be due 2 weeks before your event.

I have read, understood, and agree to the registration policies listed on this form.*

Yes

Authorized Church Representative's Signature*

Printed Name*

Children’s Retreat

SMBC Children's Retreat Registration Form - Fall 2024