Reservation Form 2011

RESERVATION FORM
~To be sent by Music Director ~

Cost: $200.00 per person
Reservations due February 15, 2011, with $100.00
deposit per camper–balance due May 1, 2011

Church________________________________

Name_________________________________

Address_______________________________

_____________________________________

Contact Person__________________________

E-mail address__________________________

Telephone Numbers (Church)_______________

(Home)____________ (Cell)_______________

♪ Total Number of Children Campers:

_________ X $100.00 = $_________

♪ Total Number of Youth Leadership Participants:

_________ X $100.00= $_________

♪ Total Number of Adult Chaperones:

_________ X $100.00= $_________

Total Reservation Fee: $________

Make checks payable to First Baptist Church and mail to:

Mark Hopper/CANTUS
First Baptist Church
205 West Winder Street
P.O. Box 75
Henderson, NC 27536