The Christian Overcomers 

Camp Volunteer Form

Camper Application

Items marked with a * are required.

*Name:
*Address:
*City:
*State:
*Zip Code:
*Home Phone:
Work Phone:
*Birthdate: (MM/DD/YY)
*Age:
*Email:
My Disability is:
Mobility: I use a WheelchairWalkerScooterAmbulatory

Attendant Status (Choose One)

I am coming indepedently

I will need Overcomers to provide an attendant for me

I am bringing my own attendant his/her name is

Any Additional Information:

I would like to attend Session: (Choose One)

Ovecomers Session I - July 12 - 16
Pastor: Jim Loveland
$50.00 deposit required with application
Registration deadline: July 6th

Ovecomers Session II - August 22 - 27
Pastor: Bob Smith
$50.00 deposit required with application
Registration deadline: August 10th

Autumn Getaway - October 11 - 15
Pastor: Bishop Charles Singletary
$50.00 deposit required with application
Registration deadline: October 12th

Please send me a scholarship application.

I am interested in monthly pre payment plan.


Christian Overcomers Staff:
Debbie White -Director
Sharon LaForge - Administrative Assitant


Cancellation Policy:

Refund given the non-refundable deposit if cancellation is received 2 weeks befor camp starts.
Confirmation and additional information will be sent upon receipt of this form and your deposit.

Filling out this form does not guarantee acceptance into our program.

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