Parents' Names:
Mailing Address:
City:
State or Province:	Alberta Alaska Alabama Arkansas Arizona British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Manitoba Maryland Maine Michigan Minnesota Missouri Mississippi Montana New Brunswick North Carolina North Dakota Nebraska Newfoundland New Hampshire New Jersey New Mexico Nova Scotia Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Prince Ed Island Puerto Rico Quebec Rhode Island South Carolina South Dakota Saskatchewan Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming None
Zip Code:
Telephone:
E-mail:
Total Number of Registrants:	1 2 3 4 5 6
Camper 1 Data
First Name:
Last Name:
Sex:	Female Male
Date of Birth:
Grade completed as of July 2010:	2nd 3rd 4th 5th 6th 7th 8th
Which Dates?	July 5–9     July 12–16

Fee Data

Choral Camp registration fees vary by date of registration and by the number of children attending from each household.

Your registration currently reflects the following information:
Number of campers you are registering –
Qualified for early registration (On or before April 1) discount? –
Calculated fees payable to Rosedale Bible College –

Please verify the accuracy of your total using the amounts in this table of fees.

Registration Date	First Child	Second Child	Each Additional Child
On or Before April 1	$225	$195	$165
After April 1	$255	$225	$195

Submitting this form will send your registration information to Choral Camp staff, but your registration will not be official until payment is received. Would you prefer to:
Make a secure payment online
Send payment by U.S. mail. (Vacancies are filled in order of paid registrations received.)

Miscellaneous