Youth & Teen Program Registration

No registrations will be accepted after June 1, 1999. (No Exceptions)
The program is for children ages 6 through 16 only.
Please use one registration sheet per child. Please Type or Print Legibly

Child's Name________________________________________Age______Birthdate__________Male/Female____

Parent's Name__________________________________________________________________________________

Address_________________________________________________City__________________________

State/Zip___________________ Phone #________________________________

____$130 - postmarked on or before May 15, 1999 ____$140 postmarked May 15 - June 1, 1999

Form of Payment: All payments must be in US dollars. We will accept a check, cashiers check

or money order. ______________----_____________________________________________

Signature of Parent or Legal Guardian ____________________________________________________________

An outstanding Youth Program has been planned for your children while you attend the Convention. They will enjoy four days and nights at Camp Fire Camp, about 45 minutes South of Fort Worth and stay in cabins there. Experienced counselors will be available at all times.

The children will be picked up at the hotel on Wednesday morning, and return to the hotel on Sunday morning. For more information on the Youth Program, telephone Kay Brewer 817-460-7322.