Apostolic Brethren Inc

Apostolic Brethren Inc. Youth Camp and Retreat Application Camper Info Name: ______Date: ______

Address: ______City: ______State: ______

Phone: ______Age: ______Male or Female (please circle one)

T-Shirt Sizes: Adult sizes Small – 4XL ______[Please choose one]

Youth Sizes: Small (6-8) – Medium (10-12) – Large (14-16) [Please Circle One] I, ______, will follow all the camp rules and give A.B.I permission to enforce these camp rules regarding myself or my child. I will participate in all activities and listen to camp counselors, Pastors, and Teachers. I am aware that I am responsible to pay for any damage caused by myself or my child and will take full responsibility for my own personal belongings.

Parent / Guardian Info

I, ______, Give my permission for myself, Son, or Daughter to attend the Apostolic Brethren Inc. Youth Camp / Convention or Spring Retreat at Camp Echoing Hills in Warsaw, Ohio. I will not hold the Apostolic Brethren, Home Church, or Camp Echoing Hills responsible for any injuries that may occur during the camp.

Parent Name: ______Phone Number: ______Parent Signature: ______Date: ______

Home Church Info Name of Church: ______Pastor’s Name: ______

Pastor’s Signature: ______Phone Number ______