F Address:_____________________________________________ Camp Code:__14NESC0617_____ Last Name:______________________________ Transportation Available Along I-80 Student Enrollment Unpaid Balance:……………......______ (Credit card payments accepted online at fcacamps.org) Payment Camp Fee:…………………………$250 Discount…………………………______ Amount Enclosed:…………...…______ Required Deposit: $100 Parent Name:____________________ Parent Home Phone:______________ Parent Work Phone:_______________ Parent Email:____________________ School you will attend in September: _______________________________ Birth Date:____/____/____ High School Graduation Year:_____ Grade/Fall ‘13_____ Register and Pay for transportation @ nebraskafca.org. (Click on “Distance Camp” in the upcoming events calendar) Pick Up and Drop Off Location: Omaha, Lincoln, Grand Island, Kearney, or North Platte? ___________________ Round Trip Bus Transportation Fee: $50 Transportation City:_____________________ State:_______ Zip:______ Phone:_______ - ______________ Email:____________________ First Name: __________________________ Gender: M Camp Enrollment Form: Distance Running Camp June 17-20 – Scottsbluff, NE Who: All Distance Runners in Cross Country or Track entering 9th-12th grade Distance Camp Cost $250 What: Registration encouraged by June 10. Space is Limited. A 4-day Distance Camp with workouts, runners from all over Nebraska, speakers, music, and training on Running with excellence for the Glory of God $100 Discount is available if needed. If accepting discount, please submit $150 with your registration. Register online at www.fcacamps.org or mail registrations to: Where: FCA - Western Nebraska P.O. Box 573 Scottsbluff, NE 69363 FCA-Nebraska believes that camps are the “training ground” for athletes and coaches to learn and apply God’s goal for their lives – “to be conformed to the likeness of his Son” Romans 8:29. We want to inspire coaches and athletes all across Nebraska to Do Sports God’s Way. Camp Schedule Rise and Shine Morning Run Breakfast and Shower Morning Chapel Lunch Huddles Team Building Running Training Free Time Evening Assembly Huddles Evening Activity Lights Out 1918 S. Beltline Hwy W Scottsbluff, NE 69361 Transportation Available: Questions? Contact: Nate Lewis - Camp Director Phone: 308-672-6953 Email: [email protected] I-80 stops include: Omaha, Lincoln, Grand Island, Kearney, and North Platte. The round trip transportation fee is $50. Register and pay @ nebraskafca.org “Like” FCA Distance Running Camp on Facebook and “Follow” @fcadistance on Twitter to stay informed during camp and throughout the year! Enrollment Instructions: 1. Complete a separate enrollment form for each camper you are enrolling. 2. Enclose a minimum deposit of $100 for each camper. If you cancel prior to the start of camp, the deposit, less a $50 service fee, will be refunded in August. After the start of Camp, the $100 deposit is non-refundable. However, substitutions may be made. Discover, Mastercard, and Visa are accepted credit cards. 3. Balance is due before check-in at camp. 2013 Distance Camp after the run to the top of the Scottsbluff National Monument 4. Mail form(s) and deposit without delay to secure your place at camp. Online registration deadline is one week prior to camp. 5. Make checks payable to: Fellowship of Christian Athletes.
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