Please read the below statements

216 North Street East, P.O. Box 602
Talladega, AL. 35161

Please read the below statements, and check each box:

	Yes, I/we understand that Camp Shocco for the Deaf, a Christian camp, is being offered to Deaf/hard of hearing boys and girls age 9 (by June 20, 2008) and above who will be enrolled in primary/secondary education during the school session of 2007-2008.
	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 Camp Shocco for the Deaf.
	Yes, I/we are also enclosing $10.00 (Children age 9-12) or $45.00 (Youth age 13 to high school) in cash, check or money order for the purpose of making application. Please make checks payable to Shocco Springs. Please mail all applications and money to: Shocco Springs, P.O. Box 886, 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! Deadline is June 20th Please print this flyer to give out to your friends.
	Yes, _______ members of my family will stay for the dinner/opening ceremony on June 29th at 5:00 pm.

Camper Information:

Child’s name: _________________________________________Age:_______ Grade: ______

Address:____________________________________________ Adult Shirt size: (S, M, L, XL) ____

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 Camp Shocco on June 29-July 5, 2008. 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 home.

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                                                                                                      Parent/Guardian Signature