BibleTimes Marketplace Tribal Assistants 2013

REGISTRATION for 2013 TRIBAL ASSISTANTS BibleTimes MarketPlace (BTMP)

Registration Deadline is May 17.

IPC members have first priority until April 17

BibleTimes MarketPlace: June 10-14, 2013

8:00 a.m. - 3:00 p.m.

Campers: Completed grades 1-5

Tribal Assistants: Completed Grades 6-12

For more information: Susan Dulin BTMP, Director (541-8606); Kristen Murphree, Co-Director (977-8126); Cindy Coulter, IPC Director Children's Ministries (218-4220)

Come live in a Hebrew tribe as a slave of Pharaoh in Egypt. Experience many daring adventures as you learn about Moses and the journey to the promised land. Be an apprentice in the marketplace and learn crafts such as pottery, weaving, carpentry and jewelry making.
Additional activities include drama, worship, storytelling, singing, games, recreation and swimming. Plan now to enjoy a fun week with friends!

Register Online

BTMP Tribal Assistant Registration

BibleTimes Marketplace 2013 June 10-14, 2013

Registration deadline is May 17. 2013. IPC members have first priority until April 17, when registration will open to non-members. Due to camp capacity, registration is limited to 135 campers. Please register early to secure your youth's place at BTMP.

Please complete a separate form for each youth.

Please fill out the entire form. The information is important to help us supervise and care for your youth.

Form for Tribal Assistants:

Youth's Name:

Full Address:

Email Address:

Girl:

Boy:

Parent's Email Address:

Youth Grade completed:

Youth Age:

School:

Are you or your family a member of IPC? Yes No

If not a member, other church affiliation

Have you previously attended BTMP? Yes No

Have you previously been a Tribal Assistant at BTMP? Yes No

Is there someone you hope to be grouped with?

Is there a specific Tribal Mother you hope to help?

YOUTH: I have read and understand my duties as a Tribal Assistant Yes No

ADDITIONAL INFORMATION TO ASSIST THE STAFF:

Are there any special concerns about your youth that the staff may need to know?

CONTACT INFORMATION:

Mother's name:

Mother's phone:

Mother's cell phone:

Father's name:

Father's phone:

Father's cell phone:

Emergency Contact/Relationship (in case mother or father cannot be reached):

Emergency phone number:

Emergency cell number:

REGISTRATION:

Registration Fee: (Scholarships available)

$35 for each youth, includes tee shirt

$25 if your youth requires bus transportation

$8 Dinner/Fun Night at IPC, Wed., June 12 (optional)

________

Total amount of your check:

Checks go to Sally Speaker at IPC

Tee Shirt Size Needed:

Youth: Medium Large

Adult: Small Medium Large

Parents: Will your youth need bus transportation to and from IPC to the CFAF?

Yes No

Parents: If "No Transporation Needed," please indicate who may pick up your youth from CFAF in the afternoon:

Name of person allowed to pick up youth:

Comments:

MEDICAL INFORMATION:

Special health problems and/or allergies for this youth:

Medication to be given during camp hours (please give dosage and time on a clearly labeled container with your youth's name):

Pediatrician Name:

Pediatrician Phone:

Name of Policy Holder:

Insurance Co/Group or Policy Number:

PERMISSION: MUST HAVE SIGNATURE

NOTE: After you click "Submit" below, you will be directed to a signature page.

On that page, you must click on the short document, print it, and sign (handwritten) the brief signature page.

After signing that form, please give that hand-signed form and your check to Sally Speaker.

NOW, CLICK "SUBMIT" to send all of the above information to Sally Speaker