Application for Work Camps at the Joe Rush Center for Urban Mission

GROUP NAME:                                                                   PHONE:                                    

ADDRESS:                                                                                                                                                                             (street)

CITY:                                                                        STATE:                       ZIP:                

CONTACT PERSON:                                                          PHONE:                               

ADDRESS:                                                                                                                            

CITY:                                                                          STATE:             ZIP:                        

E-MAIL ADDRESS _________________________________

Dates Requested: ______________________

We have a maximum of 60 beds. We will be trying to fill any unreserved space so please try to provide as accurate a count as possible.  We may not be able to add participants at a later date.

HOW MANY WILL YOU HAVE IN THE FOLLOWING GROUPS:

Adult Leaders:             Students:                      (One adult per 8-10 students)

Males:                         Females:                                              

The Joe Rush Summer Youth Camp participation fee is $250 per individual. The Camp Fee covers Lodging, Meals, Security, Interns’ Leadership, & Evening Programs. We need a $250 deposit from you immediately to hold your spot for the summer. Then we must receive half of your total balance two weeks before your group is scheduled to arrive.

Please mail applications to:

Urban Ministry Rush Center Work Camps

Attn.: Deb welsh

1229 Cotton Ave. SW

Birmingham, Alabama   35211

Signature of Group Leader or other responsible adult: