JAMAICA PENTECOSTAL CHURCH OF GOD (TRINITY)

YOUTH MINISTRIES
P.O. BOX 177, MANDEVILLE, MANCHESTER
Tel. 603-1485(Office), 461-5848 (Cell)
Email: pymjamaica_10@yahoo.com

YOUTH CAMP REGISTRATION FORM

Name in Full: __________________________________________________________________
Address: ______________________________________________________________________
Tel: __________________________________________________________________________
Email: ________________________________________________________________________
Age: ( ) 13-15 ( ) 16-19 ( ) 20-25 ( ) 26-30 ( ) 31-35 ( ) 36 & over ( )
Name of Local Church: ___________________________________________________
Name of Pastor: ___________________________ Are you a Christian: ( ) Yes ( ) No
What is your reason for coming to camp? ___________________________________________
In case of emergency contact: _____________________________________________________
Tel: ______________________ Relations: _________________________________________
Illness: ( ) Yes ( ) No Please Specify: _____________________________________________
Medication being taken: ____________________________________________________
Declaration: I promise to abide by the rules and regulations that govern the Youth Camp
accepting that if I am found in violation of these rules I will be sent home ( ) Yes ( ) No.

Signature of Participant: _____________________

Name of Pastor: _______________________ Signature of Pastor: ______________________
Name of Youth President: Signature of Youth President: ______________________

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