2009 LANDMARK CAMPMEETING
RESERVATION - REGISTRATION FORM

(mail, phone or fax to : Landmark Church 1802 Lois St. Cleveland, TN 37311 )
(Church : 423-478-1545 ~ Home : 423-472-8847 ~ Cell : 423-584-0922 ~ Cell : 423-596-8183)
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Name : ____________________________________________________________________

Age : ___________ Female : _______ Male : _________

Address : ____________________________________________________________________

City / State / Zip : _______________________________________________________

Home Phone/ Contact Numbers : ______________________________________________

Email Address : ________________________________________________________________

Church Name : __________________________________________________________________

Pastor's Name : _______________________________________________________________

REQUIRED PERSONAL SUPPLIES
-1 King James Bible
-Sleeping Bag ~ Sheets ~ Pillows
-towels, soap, toothbrush, deodorant
CampMeeting Rules
-Attend All activities/services
-No Smoking, knives, matches,
-No Fire-crackers, Boom-boxes,
-No CD players, TV's, Ipods, Mp3's
Required Working Assignments
All Adults & Campers are given
work assignments @ registration.
Adult Volunteers are Needed.

Basic Camp Code
I, _____________________________________ , understand that I may not leave the Liberty Retreat Grounds for any reason without permission from the Camp Director.

CampMeeting Dress Code
In the spirit of cooperation and modesty we ask that all comply with our dress code and the Spirit of Jesus Christ upon these grounds during the Campmeeting. We have come here to come apart from the world for a few days. Thank you.

For Girls & Women : ~ I, ______________________________________ agree to wear dresses or skirts which cover my knees during all activities & services. I agree to wear tops which cover my stomach. I agree to leave at home my jewelry, body-piercing rings, shorts, pants, culottes, gauchos, sleeve-less & low-cut blouses. I also agree to not show cleavage or my belly-button. I also agree to not complain about it.

For Boys & Men: ~ I, ______________________________________ agree to wear pants and shirts which cover my stomach during all activities & services. I also agree to leave at home all shorts and tank-tops. I also agree to not complain about it.

EMERGENCY MEDICAL TREATMENT FOR MINORS

Camper's Name : ______________________________________________________

Is camper on any medication? ... Yes or No .... If Yes, what? _____________________________________________________

Is camper allergic to any medication? ... Yes or No ... If Yes, what? _____________________________________________________

Does camper have any allergies we should know of? _____________________________________________________

In Case of Emergency Please Call:

Phone # : _________________________________

As parent or legal guardian of the above camper I grant my child permission to receive necessary medical attention which the camp nurse or camp management deems necessary for his / her well-being. In the event that a medical emergency occurs, I also agree to assume the responsibility for any medical expenses not covered by the camp insurance.

Date: __________ Parent or Guardian's Signature: ______________________________________________________________

I have read the above campmeeting rules and agree to follow them and to cooperate with all camp counselors,

leaders, and supervisors. I also understand that breaking of these rules and causing problems for others

may cause me to be moved or sent home, ....even in the middle of the night.

Camper's Signature (minor) _________________________________________________

Parent / Guardian Signature : ________________________________________________

Have A Blessed Camp !!