Yes, I/we understand that Jr. ABCD, a Christian camp, is being offered to Deaf/hard of hearing boys and girls age 13  and above who will be enrolled in High school education during the school session of 2009.
 

Yes, I/we are the parent(s) or legal guardian(s) of the child listed below.  I/we are submitting the following information in order to apply for registration to Jr. ABCD.
 

Yes, I/we are also enclosing $50.00 (Youth age 13 to high school) in cash, check or money order for the purpose of making application. Please make checks payable to Jr. ABCD.  Please mail all applications and money to: Jr. ABCD, P.O. Box 602, Talladega, AL 35161.  I/we understand that no other fees are necessary, although contributions to the camp will be accepted to support the camp.  If we receive no money, we will put your child on the waiting list.  This is a first come, first serve opportunity!

Camper Information:

Child’s name: ____________________________________Age:_______ Grade: ______

Address:____________________________________________________

City: _______________________ State: __________________ Zip Code: ____________
 

School: ___________________________________      Circle one:       Male         Female 

Phone: ______________________  Home Church: ______________________________

Contact Information:                 Email address: _____________________________

Parent’s/Guardian’s Name:___________________ Relationship to child:_____________

Address:___________________________ List all Phone numbers: _________________

City: _______________________ State:_______________ Zip Code:______________

I/We _______________________________ give my/our permission for _________________________ to attend Jr. ABCD
on March 6-8, 2009.  Our child may participate in all activities.   I/we understand that if my/our child fails to obey the established rules, I/we will be responsible for arranging transportation for my/our child to return the ASD Campus or Home.
                                                                                                                  
                                                                            _____________________________
                                                                                      Parent/Guardian Signature