YOUTH SUMMER TRIP 2016

We are excited to announce that we are taking our students to Ridgecrest, North Carolina with Student Life Summer Camps to encounter God, grow in community and be a part of meaningful service opportunities. The trip dates are July 24th - July 29th. The total cost of the trip is $650 and this includes all expenses. 

TRIP REGISTRATION FORM

Name *
Name
Phone *
Phone
Birthday *
Birthday
Parent Name *
Parent Name
Parent Phone *
Parent Phone
Parent #2 Name
Parent #2 Name
Parent #2 Phone
Parent #2 Phone
Parent Authorization
By checking the box, I authorize my child to attend summer camp in Ridgecrest, North Carolina with Antioch Community Church of Baton Rouge. By signing this application, I agree to pay the entire amount of the trip ($650), by June 31, 2016, regardless of if my child is able to attend or is not and I understand that all payments are non-refundable.

Click the button above to submit your payment after you've submitted this form.
The deposit ($100) is due upon submission of this form.