The Kerusso Experience Application Form

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July 3 - 10, 2021

Email *

Amos - Hosea - Micah ~Do Justice, Love Mercy, Walk Humbly~

Full Name *

First Name *

Last Name *

Birthdate *

YYYY

Address *

City *

State *

Zip *

Telephone *

Student's E-mail address (Please check regularly for important information and updates) *

Grade just completed *

Eighth Grade

Freshman

Sophomore

Junior

Senior

Other:

GPA *

Home congregation *

List any awards, honors, or leadership roles you have received.

Have you been baptized? *

Yes

Other:

T-Shirt size *

XXL

Write a paragraph explaining why you want to attend The Kerusso Experience. *

List and explain any commitments that would require you to leave camp early. *

List any food allergies/dietary restrictions. (Type none or n/a if no know allergies or dietary restrictions) *

Parent/Guardian Name *

Parent/Guardian E-mail (different from Student's E-mail address) *

Parent/Guardian Phone *

Reference Name *

Reference E-mail *

Reference Phone *

How did you learn about The Kerusso Experience? *

By entering your initials in the box below, you are agreeing to: I will do my very best to make the Kerusso Experience the best it can be. I will give my best to each class and my full attention to each speaker. I will give my complete effort to the preparation and delivery of the sermon topic I am assigned. I will abide by all the rules set by the staff and by Harding University. *

Would you like to pay online now with a credit card? *

Yes: http://bit.ly/2MN20O7

Please have the application and the $200 all-inclusive camp fee submitted by June 24th, 2021. Checks may be mailed to: Harding University College of Bible and Ministry - The Kerusso Experience - HU Box 12280 - Searcy, AR 72149 If you wish to submit a credit card payment later, find the link on our website: www.harding.edu/kerusso

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