2013 APOSTOLIC CHRISTIAN CHURCH

Pine Valley Retreat Application

Name  Single  Married  Male  Female

Address Age at P.V. Street City State Zip

Phone ( ) Email ______

I am willing to help in the following ways:  Wherever Needed  Song Leader  Jr. Church

 Sunday School Teacher Nursery (ages 0-1) Piano Accompanist Counselor Story hour (ages 2-5)

 Teen Teacher Adult Teacher Recreation Coordinator Craft Helper Recording Helper

Years in faith _____Home church Guardian (if under 18)

Lodging request: ______(only two names accepted) Day/Time of arrival ______

Two potential Brothers/Nominees for PV Committee (see back of application for more info):______

Complete and return application with payment to the registrar:

Mary Dragojlovic, 2411-A Vanderbilt Lane, Redondo Beach, CA 90278

Make checks/money orders payable in U.S. currency to: APOSTOLIC CHRISTIAN CHURCH OF LA PUENTE

** Each application MUST include a signed/dated “ACTIVITIES RELEASE FORM” **

(Your application is NOT considered complete without this signed/dated form).

REGISTRATIONEveryone must send in an application. Deadline is May 1, 2013!

Full or part-time and off-site MUST pre-register (which includes payment) for the following reasons:

*Motel rooms are limited and are given on a first come, first serve basis with PRIORITY going to married couples/families, elderly, and handicapped.

*Pine Valley Conference Staff (PVCS) uses registration for meal planning.

*We need to order the correct amount of classroom supplies in advance.

*There is no lodging only. If you sleep on the grounds, you must also pay for meals.

*Part-timers are encouraged to call early to arrange off-site lodging. (Pine Valley Inn - 619- 473-8560).

PAYMENT

Return completed application form along with PAYMENT IN FULL - in U.S. Currency - NO LATER THAN MAY 1. You are not registered until full payment has been received. Your application and payment indicate your agreement to abide by retreat rules. Make checks payable to: APOSTOLIC CHRISTIAN CHURCH OF LA PUENTE

Mail completed application and payment to: MARY DRAGOJLOVIC, 2411-A VANDERBILT LANE, REDONDO BEACH, CA 90278

If you have any questions, please call Mary @ 310 489-0614 or email at .

PLACEMENT

*Motel rooms are limited! Each room must have a minimum of 2 adults. It is not the registrar’s responsibility to find roommates; please make arrangements prior to pre-registering. Each person’s application and payment must be received to reserve a room.

*Family dorms are available for a minimum of 6 people (max. 12).

*Please note: Family dorms are less expensive and motel space is increasingly limited.

Please plan ahead to share a family dorm with your friends/family if at all possible. Volunteers are greatly appreciated.

It is not the registrar’s responsibility to find a family for you to share with, please make arrangements prior to pre-registering.

*All children ages 10 and younger, will be placed with their parents.

*First choice for onsite accommodations goes to full-time campers.

*All children, ages 13 and younger, must be accompanied by a parent or legal guardian to attend the retreat.

*Anyone under 18, attending without a parent or legal guardian, must have parent fill out and sign a Medical Release/

Liability waiver prior to the retreat. The form should be mailed in with the application and a guardian must be assigned.

Also, the child’s assigned guardian must be a full-time registered camper that is staying on-site.

*Requests for specific accommodations will be honored so far as practical, but final decisions will be made by the Pine Valley

Retreat Committee.

Camp begins Friday, May 24, 2013 with registration at 6:30 P.M. in the Fireside Hall.

Camp ends on Monday, May 27, after lunch. In case of an emergency, the P.V. office phone number is (619) 473-8879.

RATES: Please calculate and show the total fee due. One application per person required. Fees listed are per person.

* All rates include a $10 non-refundable registration and processing fee. / Postmarked before
May 1 / Postmarked after
May 1 / ON-SITE Rates
NOT
Pre-registered / RATE
Motel – Age 13+ (F/T with meals) *Linens included / $160 / $170 / $180 / $
Dorm - Age 13+ (F/T with meals) / $135 / $145 / $155 / $
Family Dorm - Age 13+ (min. 6 people) (F/T w/ meals) / $135 / $145 / $155 / $
9-12 years old (F/T with meals) / $110 / $120 / $130 / $
6-8 years old (F/T with meals) / $ 80 / $ 90 / $100 / $
3-5 years old (F/T with meals) / $ 60 / $ 70 / $ 80 / $
2 and under (F/T with meals) / $ 5 / $ 10 / $ 15 / $
P/T Day Registration – Child (no meals) / $ 5 / $ 10 / $ 15 / $
P/T Day Registration – age 13+ (no meals) / $ 15 / $ 25 / $ 35 / $
Day Registration (Incl. lunch) / $ 25 / $ 35 / $ 45 / $
Day Registration (Incl. dinner) / $ 25 / $ 35 / $ 45 / $
Day Registration (Incl. lunch & dinner) / $ 35 / $ 45 / $ 55 / $
All meals w/off-site lodging (all days, with registration) / $ 85 / $ 95 / $105 / $
Linens (per bed) / $ 12 / $ 12 / $ 15 / $
Donations – as unto the Lord Donation Amount / $
TOTAL DUE / $

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Cut along line and send top section with payment. Keep this bottom portion for your records.

REMEMBER TO BRING:

Bible, Zion’s Harp, bedding, towels, swimsuit cover-up (to be worn to and from pool), warm clothing, comfortable shoes, and a teachable, prayerful attitude. Proper worship attire is required for ALL functions in Worthington Hall.

**Please note that the term of two brothers on the Pine Valley Committee, Timothy Munther, and Danny Pantelic, are expiring this year. We are taking names for two potential nominees at this time (see front of application). The current P.V. Committee is Timothy Munther, Joe Greeninger, Danny Pantelic, and Jimmy Olas.

ELECTION PROCESS:

1.Each year Committee Member(s) will be elected to take the place of those whose term is expiring.

2.The Brother(s) whose term is expiring will not automatically be placed on the ballot.

3.All nominees must agree to be nominees prior to the meeting.

4.The current committee members will present a nominee for each expiring term.

5.The campers may also bring a nominee for each expiring term.

6.No more than two nominees will be accepted for each expiring term.

7.Vote will be by secret ballot at Pine Valley.

8.Each voter may mark only one name on the voting ballot for each expiring term.

9.The Brother(s) with the most votes will be the new committee member(s) to serve a three-year term.

10.The number of committee members from the same church shall be limited to two.

COMMITTEE MEMBER ELIGIBILITY:

A.Member of the A.C. Church in good standing.

B.Full- time A.C.C. Pine Valley Retreat camper.

C.Minimum of five years in the faith.

VOTER ELIGIBILITY:

I.Full-time registered Pine Valley Retreat campers, at least 16 years of age.

II.Must be present at the meeting to vote. (No proxies accepted)