Registration Form for the 2010 Green Team Camp
July 11-16, 2010

Name:

Parent's Name(s):

Address:

City:

State:

Zip Code:

Email:

Phone Number:

T-Shirt Size:

Gender:
Male
Female

Do you have any special needs?

High School:

Class of:

Why would you like to attend camp?

By submitting my registration for the 2010 SC Green Team Camp I am confirming my reservation.  Camp cost is $250 with a $50 deposit due by July 1, 2010. 
Payment can be made by mail or phone:

Phone in your credit card payment to:
Julie Headrick at 1.620.229.6141

or

Mail check payment to:
Julie Headrick
Director of Camps and Conferences
Southwestern College
100 College
Winfield, KS 67156
(Make check out to "Southwestern College")