Family Work Weekend Survey LinkedInThis field is for validation purposes and should be left unchanged.We are excited to have you join us for our annual Family Work Weekend! We value your service to Camp’s ministry and look forward to our time together. Following is the registration form for our Memorial Day Weekend event (5/24/2019 – 5/27/2019). If you have any questions regarding your registration please contact us at 260.636.7101 or at camp@lutherhaven.org.Contact InformationEmail of Parent/Guardian*Used to send registration confirmation. Enter Email Confirm Email Home Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneThis cell phone belongs to…Name of Home ChurchLocation of Home Church City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State AttendanceParticipants*Please add as many participants as necessary by hitting the "+" button on the right.AgeGenderFirst NameLast NameDate of Birth Will you be staying overnight at camp?* Yes No Which nights will you be staying at camp?* Friday night Saturday night Sunday night How many people are staying Friday night?* 1 2 3 4 5 6 7 8 How many people are staying Saturday night?* 1 2 3 4 5 6 7 8 How many people are staying Sunday night?* 1 2 3 4 5 6 7 8 (Day Workers Only) Which days will you be attending the Family Work Weekend?*If you do need housing, go back one step and select which nights you need housing. Otherwise continue. Friday Saturday Sunday Monday Housing ArrangementsHousing PreferenceAll housing is limited and assigned on a first come, first served basis. All housing utilizes community bathroom facilities. Please rank your housing preferences with most preferred at the top. Drag to re-order.Private Rooms (up to 4 people)Daniel Retreat Center (up to 8 people)Cabin (Up to 10 people)Bring Your Own TentBring Your Own RVHousing Notes & Roommate RequestsPlease include any housing notes here. Also, if you wish, list any other families that you desire to be housed with. We will do our best to honor roommate requests as long as there is capacity, availability & the request is mutual. Meal InformationPlease check how many will be eating each meal so we are able to have an accurate meal count for food ordering and preparation.Saturday Breakfast 1 2 3 4 5 6 7 8 Saturday Lunch 1 2 3 4 5 6 7 8 Saturday Dinner 1 2 3 4 5 6 7 8 Sunday Breakfast 1 2 3 4 5 6 7 8 Sunday Lunch 1 2 3 4 5 6 7 8 Sunday Dinner 1 2 3 4 5 6 7 8 Monday Breakfast 1 2 3 4 5 6 7 8 Monday Lunch 1 2 3 4 5 6 7 8 Food AllergiesPlease list any food allergies or dietary needs for the members of your family. The Lutherhaven kitchen staff will do their best to accommodate them. Your advanced notice is appreciated.
