SCCC Family Camp August 11-15, 2010

Registration Form

Instructions:

1. Fill out upper portion of Registration Form completely.

2. $20.00 deposit per lodge room, cabin or RV space is required

3. Make check of money order payable to: SCCC (Scottsville Camp & Conference Center)

4. Mail Registration Form with deposit, postmarked on or after January 15, 2010 to:

Scottsville Camp and Conference Center

PO Box 307

Scottsville, TX 75688

Call: Bill Ponder, 903 930 1226 if you want to register by phone and pay with a Credit Card

Name: _____________________________________________________________________

Address: ___________________________________________________________________

City: _____________________ State: ________________ Zip: ___________________

Preferred: Dormitory, Men’s or Women’s __________________________________

RV Space: __________________________________

Economy Cabin: __________________________________

Two-plex: __________________________________

Four-plex: __________________________________

Hamiter Lodge: (20 rooms) __________________________________

Williams Lodge: (8 rooms) __________________________________

Texas Christian Ashram Lodge: (8 rooms) ____________________________

Number of people ______and circle days attending: Wed. Thu. Fri. Sat. = Total days _______

Do not write in this box:

Deposit: ______________________________________________________________________

Check # ______________________________________________________________________

Amount ______________________________________________________________________

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