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Pine Lake Christian Camp - Family Retreat Weekend Registration Form
Please note that any field with an asterisk (*) is a required field.
If you have any questions about this event, registration form or anything else, please call our offices at (641) 858-3284 or email us at
office@iowabgc.org
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Goin' On A Lion Hunt
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Name:
*
Street Address:
*
City:
*
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
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Louisiana
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Maryland
Massachusetts
Michigan
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Mississippi
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Montana
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North Carolina
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
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Zip Code:
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Home Phone:
Mobile Phone:
E-mail Address:
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Church:
First Baptist, Algona
Pleasant View Baptist, Bettendorf
Community Fellowship, Blue Grass
West Avenue Baptist, Burlington
Prairie Lakes, Cedar Falls
Edgewood Family Fellowship, Cedar Rapids
Valley View Baptist, Cedar Rapids
Grandview Baptist, Davenport
Hope Evangelical, Davenport
Grace Fellowship, Decorah
Denison Bsptist, Denison
Denver Baptist, Denver
Asian American Fellowship, Des Moines
New Life, Des Moines
Union Park Baptist, Des Moines
Cornerstone Baptist, Eldridge
Grandview Baptist, Estherville
First Baptist, Forest City
Calvary Baptist, Fort Dodge
Faith Baptist, Hampton
Oak Hill Baptist, Humboldt
Faith Community, Ida Grove
The River Community, Iowa City
The River's Edge, Iowa Falls
Jesup Bible Fellowship, Jesup
First Baptist, Kiron
New Covenant Baptist, Knoxville
Center Baptist, Lansing
Milford Baptist, Milford
First Baptist, Muscatine
First Baptist, New Hampton
Genesis, North Liberty
Grace Community, Pleasant Hill
Morningside Baptist, Sioux City
First Baptist, Stratford
Olivet Baptist, Urbandale
Faith Baptist, Washington
Grace Baptist, Waterloo
Grace Baptist, Waverly
Ironridge, Waukon
West Liberty Christian Fellowship, West Liberty
Other (please type below)
Home Church:
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Choose your Family Retreat Weekend:
Memorial Day Family Retreat Weekend (May 23rd - 26th)
4th of July Family Retreat Weekend (July 3rd - July 6th)
Homecoming Weekend (August 1st - 3rd)
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Lodging: "Memorial Day" or "4th of July" Weekends:
Parr Lodge Room (2 twin beds, private bath) ($120)
Cabin (sleeps up to 9, private and shared baths) ($150)
RV w/ water, sewer, electric ($75)
RV w/ electric only ($60)
RV or Tent w/out hook-ups ($45)
*
Lodging - Homecoming Weekend:
Parr Lodge Room (2 twin beds, private bath) ($80)
Cabin (sleeps up to 9, private and shared baths) ($100)
RV w/ water, sewer, electric ($50)
RV w/ electric only ($40)
RV or Tent w/out hook-ups ($30)
*
Program Fee - Please enter number of adults attending (required for those 9 and older):
1 adult ($25)
2 adults ($50)
3 adults ($75)
4 or more adults ($100)
Meal Choices - "Memorial Day" or "4th of July" Weekends - Option 1 (Package Plan):
1 Adult (ages 9 and up) - All 7 Meals ($42/each)
2 Adults (ages 9 and up) - All 7 Meals ($42/each)
3 Adults (ages 9 and up) - All 7 Meals ($42/each)
4 Adults (ages 9 and up) - All 7 Meals ($42/each)
5 Adults (ages 9 and up) - All 7 Meals ($42/each)
6 Adults (ages 9 and up) - All 7 Meals ($42/each)
7 Adults (ages 9 and up) - All 7 Meals ($42/each)
8 Adults (ages 9 and up) - All 7 Meals ($42/each)
1 Child (ages 4 to 8) - All 7 Meals ($21/each)
2 Children (ages 4 to 8) - All 7 Meals ($21/each)
3 Children (ages 4 to 8) - All 7 Meals ($21/each)
4 Children (ages 4 to 8) - All 7 Meals ($21/each)
5 Children (ages 4 to 8) - All 7 Meals ($21/each)
6 Children (ages 4 to 8) - All 7 Meals ($21/each)
7 Children (ages 4 to 8) - All 7 Meals ($21/each)
8 Children (ages 4 to 8) - All 7 Meals ($21/each)
Meal Choices - "Memorial Day" Weekend - Option 2 (A la carte plan):
Saturday Breakfast - 1 Adult (9 and up) ($7/each)
Saturday Breakfast - 2 Adults (9 and up) ($7/each)
Saturday Breakfast - 3 Adults (9 and up) ($7/each)
Saturday Breakfast - 4 Adults (9 and up) ($7/each)
Saturday Breakfast - 5 Adults (9 and up) ($7/each)
Saturday Breakfast - 6 Adults (9 and up) ($7/each)
Saturday Breakfast - 7 Adults (9 and up) ($7/each)
Saturday Breakfast - 8 Adults (9 and up) ($7/each)
Saturday Breakfast - 1 Child (ages 4 to 8) ($4/each)
Saturday Breakfast - 2 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 3 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 4 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 5 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 6 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 7 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 8 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 1 Adult (9 and up) ($7/each)
Saturday Lunch - 2 Adults (9 and up) ($7/each)
Saturday Lunch - 3 Adults (9 and up) ($7/each)
Saturday Lunch - 4 Adults (9 and up) ($7/each)
Saturday Lunch - 5 Adults (9 and up) ($7/each)
Saturday Lunch - 6 Adults (9 and up) ($7/each)
Saturday Lunch - 7 Adults (9 and up) ($7/each)
Saturday Lunch - 8 Adults (9 and up) ($7/each)
Saturday Lunch - 1 Child (ages 4 to 8) ($4/each)
Saturday Lunch - 2 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 3 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 4 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 5 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 6 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 7 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 8 Children (ages 4 to 8) ($4/each)
Saturday Supper - 1 Adult (9 and up) ($7/each)
Saturday Supper - 2 Adults (9 and up) ($7/each)
Saturday Supper - 3 Adults (9 and up) ($7/each)
Saturday Supper - 4 Adults (9 and up) ($7/each)
Saturday Supper - 5 Adults (9 and up) ($7/each)
Saturday Supper - 6 Adults (9 and up) ($7/each)
Saturday Supper - 7 Adults (9 and up) ($7/each)
Saturday Supper - 8 Adults (9 and up) ($7/each)
Saturday Supper - 1 Child (ages 4 to 8) ($4/each)
Saturday Supper - 2 Children (ages 4 to 8) ($4/each)
Saturday Supper - 3 Children (ages 4 to 8) ($4/each)
Saturday Supper - 4 Children (ages 4 to 8) ($4/each)
Saturday Supper - 5 Children (ages 4 to 8) ($4/each)
Saturday Supper - 6 Children (ages 4 to 8) ($4/each)
Saturday Supper - 7 Children (ages 4 to 8) ($4/each)
Saturday Supper - 8 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 1 Adult (9 and up) ($7/each)
Sunday Breakfast - 2 Adults (9 and up) ($7/each)
Sunday Breakfast - 3 Adults (9 and up) ($7/each)
Sunday Breakfast - 4 Adults (9 and up) ($7/each)
Sunday Breakfast - 5 Adults (9 and up) ($7/each)
Sunday Breakfast - 6 Adults (9 and up) ($7/each)
Sunday Breakfast - 7 Adults (9 and up) ($7/each)
Sunday Breakfast - 8 Adults (9 and up) ($7/each)
Sunday Breakfast - 1 Child (ages 4 to 8) ($4/each)
Sunday Breakfast - 2 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 3 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 4 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 5 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 6 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 7 Children (ages 4 to 8) ($4/each)
Sunday Breakfast - 8 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 1 Adult (9 and up) ($7/each)
Sunday Lunch - 2 Adults (9 and up) ($7/each)
Sunday Lunch - 3 Adults (9 and up) ($7/each)
Sunday Lunch - 4 Adults (9 and up) ($7/each)
Sunday Lunch - 5 Adults (9 and up) ($7/each)
Sunday Lunch - 6 Adults (9 and up) ($7/each)
Sunday Lunch - 7 Adults (9 and up) ($7/each)
Sunday Lunch - 8 Adults (9 and up) ($7/each)
Sunday Lunch - 1 Child (ages 4 to 8) ($4/each)
Sunday Lunch - 2 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 3 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 4 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 5 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 6 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 7 Children (ages 4 to 8) ($4/each)
Sunday Lunch - 8 Children (ages 4 to 8) ($4/each)
Sunday Supper - 1 Adult (9 and up) ($7/each)
Sunday Supper - 2 Adults (9 and up) ($7/each)
Sunday Supper - 3 Adults (9 and up) ($7/each)
Sunday Supper - 4 Adults (9 and up) ($7/each)
Sunday Supper - 5 Adults (9 and up) ($7/each)
Sunday Supper - 6 Adults (9 and up) ($7/each)
Sunday Supper - 7 Adults (9 and up) ($7/each)
Sunday Supper - 8 Adults (9 and up) ($7/each)
Sunday Supper - 1 Child (ages 4 to 8) ($4/each)
Sunday Supper - 2 Children (ages 4 to 8) ($4/each)
Sunday Supper - 3 Children (ages 4 to 8) ($4/each)
Sunday Supper - 4 Children (ages 4 to 8) ($4/each)
Sunday Supper - 5 Children (ages 4 to 8) ($4/each)
Sunday Supper - 6 Children (ages 4 to 8) ($4/each)
Sunday Supper - 7 Children (ages 4 to 8) ($4/each)
Sunday Supper - 8 Children (ages 4 to 8) ($4/each)
Monday Brunch - 1 Adult (9 and up) ($8/each)
Monday Brunch - 2 Adults (9 and up) ($8/each)
Monday Brunch - 3 Adults (9 and up) ($8/each)
Monday Brunch - 4 Adults (9 and up) ($8/each)
Monday Brunch - 5 Adults (9 and up) ($8/each)
Monday Brunch - 6 Adults (9 and up) ($8/each)
Monday Brunch - 7 Adults (9 and up) ($8/each)
Monday Brunch - 8 Adults (9 and up) ($8/each)
Monday Brunch - 1 Child (ages 4 to 8) ($4/each)
Monday Brunch - 2 Children (ages 4 to 8) ($4/each)
Monday Brunch - 3 Children (ages 4 to 8) ($4/each)
Monday Brunch - 4 Children (ages 4 to 8) ($4/each)
Monday Brunch - 5 Children (ages 4 to 8) ($4/each)
Monday Brunch - 6 Children (ages 4 to 8) ($4/each)
Monday Brunch - 7 Children (ages 4 to 8) ($4/each)
Monday Brunch - 8 Children (ages 4 to 8) ($4/each)
Meal Choices - "4th of July" Weekend - Option 2 (A la carte plan):
Friday Breakfast - 1 Adult (9 and up) ($7/each)
Friday Breakfast - 2 Adults (9 and up) ($7/each)
Friday Breakfast - 3 Adults (9 and up) ($7/each)
Friday Breakfast - 4 Adults (9 and up) ($7/each)
Friday Breakfast - 5 Adults (9 and up) ($7/each)
Friday Breakfast - 6 Adults (9 and up) ($7/each)
Friday Breakfast - 7 Adults (9 and up) ($7/each)
Friday Breakfast - 8 Adults (9 and up) ($7/each)
Friday Breakfast - 1 Child (ages 4 to 8) ($4/each)
Friday Breakfast - 2 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 3 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 4 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 5 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 6 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 7 Children (ages 4 to 8) ($4/each)
Friday Breakfast - 8 Children (ages 4 to 8) ($4/each)
Friday Lunch - 1 Adult (9 and up) ($7/each)
Friday Lunch - 2 Adults (9 and up) ($7/each)
Friday Lunch - 3 Adults (9 and up) ($7/each)
Friday Lunch - 4 Adults (9 and up) ($7/each)
Friday Lunch - 5 Adults (9 and up) ($7/each)
Friday Lunch - 6 Adults (9 and up) ($7/each)
Friday Lunch - 7 Adults (9 and up) ($7/each)
Friday Lunch - 8 Adults (9 and up) ($7/each)
Friday Lunch - 1 Child (ages 4 to 8) ($4/each)
Friday Lunch - 2 Children (ages 4 to 8) ($4/each)
Friday Lunch - 3 Children (ages 4 to 8) ($4/each)
Friday Lunch - 4 Children (ages 4 to 8) ($4/each)
Friday Lunch - 5 Children (ages 4 to 8) ($4/each)
Friday Lunch - 6 Children (ages 4 to 8) ($4/each)
Friday Lunch - 7 Children (ages 4 to 8) ($4/each)
Friday Lunch - 8 Children (ages 4 to 8) ($4/each)
Friday Supper - 1 Adult (9 and up) ($7/each)
Friday Supper - 2 Adults (9 and up) ($7/each)
Friday Supper - 3 Adults (9 and up) ($7/each)
Friday Supper - 4 Adults (9 and up) ($7/each)
Friday Supper - 5 Adults (9 and up) ($7/each)
Friday Supper - 6 Adults (9 and up) ($7/each)
Friday Supper - 7 Adults (9 and up) ($7/each)
Friday Supper - 8 Adults (9 and up) ($7/each)
Friday Supper - 1 Child (ages 4 to 8) ($4/each)
Friday Supper - 2 Children (ages 4 to 8) ($4/each)
Friday Supper - 3 Children (ages 4 to 8) ($4/each)
Friday Supper - 4 Children (ages 4 to 8) ($4/each)
Friday Supper - 5 Children (ages 4 to 8) ($4/each)
Friday Supper - 6 Children (ages 4 to 8) ($4/each)
Friday Supper - 7 Children (ages 4 to 8) ($4/each)
Friday Supper - 8 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 1 Adult (9 and up) ($7/each)
Saturday Breakfast - 2 Adults (9 and up) ($7/each)
Saturday Breakfast - 3 Adults (9 and up) ($7/each)
Saturday Breakfast - 4 Adults (9 and up) ($7/each)
Saturday Breakfast - 5 Adults (9 and up) ($7/each)
Saturday Breakfast - 6 Adults (9 and up) ($7/each)
Saturday Breakfast - 7 Adults (9 and up) ($7/each)
Saturday Breakfast - 8 Adults (9 and up) ($7/each)
Saturday Breakfast - 1 Child (ages 4 to 8) ($4/each)
Saturday Breakfast - 2 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 3 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 4 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 5 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 6 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 7 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 8 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 1 Adult (9 and up) ($7/each)
Saturday Lunch - 2 Adults (9 and up) ($7/each)
Saturday Lunch - 3 Adults (9 and up) ($7/each)
Saturday Lunch - 4 Adults (9 and up) ($7/each)
Saturday Lunch - 5 Adults (9 and up) ($7/each)
Saturday Lunch - 6 Adults (9 and up) ($7/each)
Saturday Lunch - 7 Adults (9 and up) ($7/each)
Saturday Lunch - 8 Adults (9 and up) ($7/each)
Saturday Lunch - 1 Child (ages 4 to 8) ($4/each)
Saturday Lunch - 2 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 3 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 4 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 5 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 6 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 7 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 8 Children (ages 4 to 8) ($4/each)
Saturday Supper - 1 Adult (9 and up) ($7/each)
Saturday Supper - 2 Adults (9 and up) ($7/each)
Saturday Supper - 3 Adults (9 and up) ($7/each)
Saturday Supper - 4 Adults (9 and up) ($7/each)
Saturday Supper - 5 Adults (9 and up) ($7/each)
Saturday Supper - 6 Adults (9 and up) ($7/each)
Saturday Supper - 7 Adults (9 and up) ($7/each)
Saturday Supper - 8 Adults (9 and up) ($7/each)
Saturday Supper - 1 Child (ages 4 to 8) ($4/each)
Saturday Supper - 2 Children (ages 4 to 8) ($4/each)
Saturday Supper - 3 Children (ages 4 to 8) ($4/each)
Saturday Supper - 4 Children (ages 4 to 8) ($4/each)
Saturday Supper - 5 Children (ages 4 to 8) ($4/each)
Saturday Supper - 6 Children (ages 4 to 8) ($4/each)
Saturday Supper - 7 Children (ages 4 to 8) ($4/each)
Saturday Supper - 8 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 1 Adult (9 and up) ($8/each)
Sunday Brunch - 2 Adults (9 and up) ($8/each)
Sunday Brunch - 3 Adults (9 and up) ($8/each)
Sunday Brunch - 4 Adults (9 and up) ($8/each)
Sunday Brunch - 5 Adults (9 and up) ($8/each)
Sunday Brunch - 6 Adults (9 and up) ($8/each)
Sunday Brunch - 7 Adults (9 and up) ($8/each)
Sunday Brunch - 8 Adults (9 and up) ($8/each)
Sunday Brunch - 1 Child (ages 4 to 8) ($4/each)
Sunday Brunch - 2 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 3 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 4 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 5 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 6 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 7 Children (ages 4 to 8) ($4/each)
Sunday Brunch - 8 Children (ages 4 to 8) ($4/each)
Meal Choices - "Homecoming" Weekend - Option 1 (Package Plan):
1 Adult (ages 9 and up) - All 4 Meals ($24/each)
2 Adults (ages 9 and up) - All 4 Meals ($24/each)
3 Adults (ages 9 and up) - All 4 Meals ($24/each)
4 Adults (ages 9 and up) - All 4 Meals ($24/each)
5 Adults (ages 9 and up) - All 4 Meals ($24/each)
6 Adults (ages 9 and up) - All 4 Meals ($24/each)
7 Adults (ages 9 and up) - All 4 Meals ($24/each)
8 Adults (ages 9 and up) - All 4 Meals ($24/each)
1 Child (ages 4 to 8) - All 4 Meals ($12/each)
2 Children (ages 4 to 8) - All 4 Meals ($12/each)
3 Children (ages 4 to 8) - All 4 Meals ($12/each)
4 Children (ages 4 to 8) - All 4 Meals ($12/each)
5 Children (ages 4 to 8) - All 4 Meals ($12/each)
6 Children (ages 4 to 8) - All 4 Meals ($12/each)
7 Children (ages 4 to 8) - All 4 Meals ($12/each)
8 Children (ages 4 to 8) - All 4 Meals ($12/each)
Meal Choices - "Homecoming" Weekend - Option 2 (A la carte plan):
Saturday Breakfast - 1 Adult (9 and up) ($7/each)
Saturday Breakfast - 2 Adults (9 and up) ($7/each)
Saturday Breakfast - 3 Adults (9 and up) ($7/each)
Saturday Breakfast - 4 Adults (9 and up) ($7/each)
Saturday Breakfast - 5 Adults (9 and up) ($7/each)
Saturday Breakfast - 6 Adults (9 and up) ($7/each)
Saturday Breakfast - 7 Adults (9 and up) ($7/each)
Saturday Breakfast - 8 Adults (9 and up) ($7/each)
Saturday Breakfast - 1 Child (ages 4 to 8) ($4/each)
Saturday Breakfast - 2 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 3 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 4 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 5 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 6 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 7 Children (ages 4 to 8) ($4/each)
Saturday Breakfast - 8 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 1 Adult (9 and up) ($7/each)
Saturday Lunch - 2 Adults (9 and up) ($7/each)
Saturday Lunch - 3 Adults (9 and up) ($7/each)
Saturday Lunch - 4 Adults (9 and up) ($7/each)
Saturday Lunch - 5 Adults (9 and up) ($7/each)
Saturday Lunch - 6 Adults (9 and up) ($7/each)
Saturday Lunch - 7 Adults (9 and up) ($7/each)
Saturday Lunch - 8 Adults (9 and up) ($7/each)
Saturday Lunch - 1 Child (ages 4 to 8) ($4/each)
Saturday Lunch - 2 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 3 Children (ages 4 to 8) ($4/each)
Saturday Lunch - 4 Children (ages 4 to 8) ($4/each)