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Twin Lakes Ranch Ministries Inc.
Ron & Lorna Silvester
Box 1175 Moose Jaw, SK S6H 4P9
Phone 306-692-3210 Fax 306-692-3424
 www.twinlakesranchministries.com
E-mail  twinlakesranch@sasktel.net
 

PRESENTS:   Date July 7-10, 2008

Rodeo Bible Camp at Sim Qua Ranch, Kola MB

Note This registration form is for camp only.  If you are wanting to register for one of the schools click here
Registration & Release Form – Please Print 

NAME EVENT ENTERED (CHECK ONE)
 ____________________________________________
ADDRESS ______ Rodeo Bible Camp at Kola, MB
____________________________________________
CITY FEES:
____________________________________________ $225
PROVINCE_________ POSTAL CODE ___________ Deposit required $100 (non-refundable)
 PHONE # (_____) ___________________  
BIRTHDAY _______________AGE __________
HEALTH CARD # ____________________________ YOUR DEPOSIT $ ________________
Do you have accident insurance?_________ BALANCE DUE $ _________________
Accident Insurance Policy____________________ EMAIL ADDRESS____________________

WAIVER TO BE SIGNED BY A COMMISSIONER FOR OATHS OR NOTARY PUBLIC

I hereby agree to waive and release any and all claims for personal accident, injury and or loss to myself, my family, my equipment or my animals now or in the future

to Twin Lakes Ranch Ministries, Inc, staff, instructors, board and/or Ron & Lorna Silvester and family, Sim Qua Ranch, Wayne and Liz Plett and family.

Declared before me at __________________________ in the Province of _____________________________

This ___________ day of _______________________.

Signature of a Commissioner For Oaths or Notary Public

My Commission expires _________________________________________________

Applicant’s Signature __________________________________________

If under 18 yr both Parents/Guardians must sign ______________________________                    

Please no alcohol or drugs    home page