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Ck. Balance Due if applicable Miscellaneous Notes Pastor Church Ck. Money Order PA DISTRICT U. P. C. Sun. Mon. Tues. Wed. Thurs. th MAILING INSTRUCTIONS Mail your Registration Form Medical Emergency Form and payment in full to Talina Lutz 607 E. Walnut St. Lewistown PA. Signature of your U. P. C. I. Pastor or Sectional Presbyter if you do not attend a U. P. C. I. church I understand that if the applicant violates the campground policies it will be brought to my attention and the applicant may...
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