Rosalums Registration Form

Any changes to your information?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Birth Date (minimum age: 22)

MonthDayYear

Phone Number

Area CodePhone Number

Profession

Closest Region

Summer Camp Involvement. Please use the calendar years (ex: 1992-1994), and leave spaces blank for the roles that are not applicable to you.

Would you like to add a spouse to your membership?

Spouse Name

First NameLast Name

Spouse Birth Date

MonthDayYear

Spouse Email

example@example.com

Spouse Phone Number

Area CodePhone Number

Spouse Profession

Spouse Summer Camp Involvement. Please use the calendar years (ex: 1992-1994), and leave spaces blank for the roles that are not applicable to you.

If you have any children, please list their names and ages below.

The Rosalums have four committees that are led by the Board of the Directors. Members are encouraged to serve with a committee as needed and as their gifts, interests, and time constraints allow.

Committees of Interest

Do you have any skills or contacts that would benefit the success of the organization?

Photography, potential auction items, venue or caterer connections, etc

Join our community! Roslaums' annual membership fee will automatically renew one year from the date you sign up. We will email you prior to this charge as a reminder. If you wish to cancel or update your card information, simply contact Camp Allen at rosalums@campallen.org or 936-825-7175.

This nominal donation helps offset events and supplies. Remaining funds will be used to support the summer camp program or scholarships. Please save your email receipt for tax purposes.

Membership

Rosalums Annual Membership - Individual($35.00 for each year)

Rosalums Annual Membership - Couple ($50.00 for each year)

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Membership Registration

Membership*

Membership