Who: Anyone who is 13yrs to 21yrs old.
Date: 16-19 December 2011
Time: Leaving on Friday and returning before lunch on Monday.
Where: Sumcay
Cost: R350 includes accommodation and meals
If you would like a camp t-shirt you need to include and extra R50

Closing date:
Your forms must be handed in to your youth pastor by the 28th November or to the SU offices (1 King George's Road, Mill Park, Port Elizabeth, 6001) by the 30th November 2011

Getting to camp:
* You need to find your own transport to the camp.
* Registration will take place from 4pm on Friday at Sumcay

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Please fill in all the details and hand it to your Youth Pastor or to the SU office 1 King George's Road Mill Park Port Elizabeth.  This form must be accompanied by the relevant camp fee.

PLEASE WRITE IN BLOCK LETTERS.

SURNAME: ................................................   NAME: .......................................................................

ADDRESS: ...................................................................................................................................

EMAIL: ..........................................................................................                  AGE: .............

BIRTH DATE (DD/MM/YY): .......................................

SCHOOL: .....................................................       GRADE: ..........         GENDER: M / F (pls circle)

HOME TEL: (    ) .............................................  CELL: .......................................................

CAMP T-SHIRT (R50 over and above the camp fees)   YES / NO (pls circle)        SIZE:  S / M / L / XL (pls circle)

ARE YOU A VEGETARIAN?       YES / NO (pls circle)

OTHER DIETARY REQUIREMENTS: ..........................................................................................................

I hereby declare to abide by all the rules of the camp and its leaders.


____________________________                 _________________ 
     CAMPER SIGNATURE                                          DATE

I, the parent / guardian do hereby indemnify Scripture Union and any of their organisers or leaders against any loss, damage or injury caused by any person or property for whatever cause, either directly or indirectly, at the Summer Life Camp 16-19 December 2011, and not to regard them responsible for any such event related to the above camp.

I hereby give permission for my child to attend the Summer Life Camp


SIGNATURE OF PARENT/GUARDIAN: ................................................................    DATE: .................................

PARENT OR GUARDIAN NAME: ....................................................................................

CELL NO: ....................................................................................

ANY MEDICAL REQUIREMENTS: .....................................................................................

MEDICAL AID NAME: .................................................................................................

MEDICAL AID NUMBER: .........................................................