Emmanuel Heights Checklist

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Please complete the following checklist and click on "Send"

We must receive the information a week before your scheduled retreat/camp date.

If you have any questions please email or call Becky at 805-238-3582.

Church/Organization Name
Group Leader's First Name
Last Name
Phone Number	Is this your Church Home Cell Work
Alternate Phone Number	Is this your Church Home Cell Work
Email Address
Retreat/Camp Dates	to

Certificate of Insurance	Mailed Faxed (to Emmanuel Heights 2 weeks prior to arrival)
Camp/Retreat Schedule	Mailed Emailed Faxed (to Emmanuel Heights 1 week prior to arrival)

Desired meal plan	Check here if you would like dinner served at 6 pm on your first night only
Final Number
Youth & single groups	# of females # of males

Would you like to use the speaker's cabin?	Yes No
Would you like to use the speaker's cabin?	(There is 1 cabin that sleep approximately 3-4 people and is located about 1/4 mile from the main complex. The cost is $3 more per person per night. Linens are provided)

Do you need the swimming pool?	Yes No (available May 1 through November 1)
Would you like to use the sports equipment, bikes and canoes?	Yes No PLEASE NOTE: There is a $200 deposit required for the use of the equipment. It is refundable if the equipment is returned in satisfactory condition. Please bring cash or a check with you for the deposit. Do not add it into your final bill. We also have ping pong balls available at a cost of $0.25 each.

Would you like to use the audio/visual equipment we have available?	Yes No If yes, which ones? (Choose all that apply) TV VCR DVD player Overhead projector PLEASE NOTE: There is a $200 deposit required for the use of the equipment. It is refundable if the equipment is returned in satisfactory condition. Please bring cash or a check with you for the deposit. Do not add it into your final bill.

Do you need any special meals?	Yes No If yes, note the type and the number needed Type of meal Number of guests on special meals Type of meal Number of guests on special meals Type of meal Number of guests on special meals Additional comments concerning special meals

Would you like a bonfire?	Yes No To choose more than one day, hold down the 'Ctrl' button and click on the desired days (Must be started no later than 9:00 P.M. and finished by 10:00 P.M. or earlier)

Additional Comments/Questions