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    Number Your Days Retreat Form

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    Calvary Baptist Church, Washington, DC
    This participation form is for the "Number Your Days" retreat taking place on March 3, 2013 at Camp Fraser located at 101 Springvale Rd. in Great Falls, VA. It requests the participant's name, contact information, allergies, needs, and includes a liability waiver releasing Calvary Baptist Church from any responsibility resulting from activities during the retreat. An emergency contact and their phone number is also required, along with a list of recommended items to bring including closed-toe shoes, a Bible, notebook, the participation form, and a $15 fee.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Number Your Days Retreat Form

    Uploaded by

    Calvary Baptist Church, Washington, DC
    71 views2 pages
    This participation form is for the "Number Your Days" retreat taking place on March 3, 2013 at Camp Fraser located at 101 Springvale Rd. in Great Falls, VA. It requests the participant's name, contact information, allergies, needs, and includes a liability waiver releasing Calvary Baptist Church from any responsibility resulting from activities during the retreat. An emergency contact and their phone number is also required, along with a list of recommended items to bring including closed-toe shoes, a Bible, notebook, the participation form, and a $15 fee.

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    Number Your Days Retreat Form

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    © Attribution Non-Commercial (BY-NC)

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    This participation form is for the "Number Your Days" retreat taking place on March 3, 2013 at Camp Fraser located at 101 Springvale Rd. in Great Falls, VA. It requests the participant's name, contact information, allergies, needs, and includes a liability waiver releasing Calvary Baptist Church from any responsibility resulting from activities during the retreat. An emergency contact and their phone number is also required, along with a list of recommended items to bring including closed-toe shoes, a Bible, notebook, the participation form, and a $15 fee.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    71 views2 pages

    Number Your Days Retreat Form

    Uploaded by

    Calvary Baptist Church, Washington, DC
    This participation form is for the "Number Your Days" retreat taking place on March 3, 2013 at Camp Fraser located at 101 Springvale Rd. in Great Falls, VA. It requests the participant's name, contact information, allergies, needs, and includes a liability waiver releasing Calvary Baptist Church from any responsibility resulting from activities during the retreat. An emergency contact and their phone number is also required, along with a list of recommended items to bring including closed-toe shoes, a Bible, notebook, the participation form, and a $15 fee.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Number Your Days Retreat

    Participation Form
    March 3, 2013, Camp Fraser
    101 Springvale Rd. Great Falls, VA 22066
    Name:_______________________________________________________________________
    Phone: ______________________________________________________________________
    Email: _______________________________________________________________________
    Allergies:_____________________________________________________________________
    ____________________________________________________________________________
    Please list any other needs:
    ___________________________________________________________________________________
    ___________________________________________________________________________________

    I, the undersigned, hereby agree to indemnify and hold harmless Calvary Baptist Church, its
    Board of Trustees, its officers, employees and staff, from any liability as a result of either
    intentional acts or negligence, or failure to act on the part of any of the above named entities or
    persons as a result of the use of the premises while I am participating in any activities while at
    the Number Your Days Retreat at Camp Fraser, March 3, 2013.
    Signature: _________________________________________ Date: _____________________
    Emergency Contact: ___________________________________________________________
    Phone Number for Emergency Contact: ____________________________________________
    Items to Bring
    1. Closed-toed shoes
    2. Bible, notebook (if desired)
    3. Participant form
    4. $15 fee (Scholarships available; please contact Rachel Johnson,[email protected])

    Retiro: Contando Nuestros Dias


    Formulario de Participacion
    3 de marzo, 2013, Camp Fraser
    101 Springvale Rd. Great Falls, VA 22066
    Nombre:_____________________________________________________________________
    Telefono: ____________________________________________________________________
    Email: _______________________________________________________________________
    Alergias:_____________________________________________________________________
    ____________________________________________________________________________
    Por favor escriba cualquier otra necesidad:
    ___________________________________________________________________________________
    ___________________________________________________________________________________

    Yo, el abajo firmante se compromete a indemnizar y mantener indemne a Calvary Baptist


    Church, de su Consejo de Administracin, sus funcionarios, empleados y agentes, de cualquier
    responsabilidad como resultado de cualquiera de los actos intencionales o negligencia u
    omisin por parte de cualquier del antes mencionado entidades o personas como consecuencia
    de la utilizacin de los locales mientras estoy participando en ninguna actividad, mientras que
    participo en el Retiro: Contando Nuestros Dias en el Campamento Fraser, 3 de marzo, 2012.
    Firma: _________________________________________ Fecha: _____________________
    Nombre de Contacto de Emergencia______________________________________________
    Nmero de telfono para contacto de emergencia: __________________________________
    Para Traer
    1. Zapatos cerrados
    2. Biblia, cuaderno (si se desea)
    3. Formulario de Participacion
    4. Pago de $15 (Becas estan disponibles; porfavor contactar a Rachel Johnson,
    [email protected])

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