Hosted Retreat Registration Form

* Denotes Required Field

Your Gender:* Male Female

First Name:* Last Name:*

Address:*

City:* ST:* Zip:*

Phone - ###-###-####* Email:*

Birthday - MM/DD/YYYY* Attending Church:

Retreat Name:*

Comments / Questions:

Payment Options (Choose One):
Check / Money Order (Address will be on next screen)
PayPal / Credit Card (This option will be available after you "Send" this form.)
I would like a Scholarship Application

Authorization Form (Please read carefully before accepting):

By submitting this registration form, I understand and certify that participation in New Life Bible Camp and its activities is completely voluntary and I have familiarized myself with the camp's program and activities in which I will be participating. I recognize that certain hazards and dangers are inherent in camp events and programs, and particularly but not limited to the activities of hiking, horses, organized recreational activities and games, and team building activities. I acknowledge that although New Life Bible Camp has taken safety measures to minimize the risk of injury to camp participants, New Life cannot ensure nor guarantee that the participants, equipment, premises and/or activities will be free of hazards, accidents and/or injuries. I further recognize the importance of knowing and abiding by the camp's rules, regulations and procedures for safety of all camp participants. By my acceptance below, I agree to indemnify, waive all claims, and hold New Life Bible Camp harmless against any and all costs, damages, and expenses which may be incurred by them as a result of any lawsuit I (or my agents) might file against them or arising from my participation in activities at New Life Bible Camp. I also hereby give my permission to the physician selected by the camp to hospitalize, secure proper treatment for; and order injection, anesthesia, or surgery for me. I also grant permission for the above named to be included in camp photos, audio, and/or video that may be used for promotional purposes.

*I agree to the terms of the Authorization Form above.