Beulahland Retreat and Workshop Registration

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Please fill out this form for the appropriate retreat or workshop. We are grateful for a generous donation which covers the original $68 cost of this retreat. If you would like to make a donation while at camp please do so.

Renessa *

Last Name *

Street Address *

City *

State *

Birthdate *

YYYY

Sex *

Male

Female

Cell # *

Email *

Emergency Contact Information *

Retreat/Workshop *

Do you need overnight accommodations? *

Yes (if yes, please bring personal items including twin bedding and towel)

Photos (no names) of participants may be used on camp website to promote Beulahland Christian Camp. Do you give permission to this?
*

Yes

Food Allergies (Please specify) *

Payment method the day of the event. *

Cash

Check

Submit

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