Grace Island



ORGANIZATION: ____________________________________________________________________________

ADDRESS: _________________________________________________________________________________

STATED PURPOSE OF ORGANIZATION: ___________________________________________________________

_________________________________________________________________________________________

STATED PURPOSE OF VISIT: ___________________________________________________________________

_________________________________________________________________________________________

CONTACT #1: NAME _____________________________________________________________________

PHONE:   Home _____________ Work _____________ ext. _____ Cellular _____________

CONTACT #2: NAME _____________________________________________________________________

PHONE:   Home _____________ Work _____________ ext. _____ Cellular _____________

DATE REQUESTED: From __________________________ to __________________________

SECOND CHOICE: From __________________________ to ___________________________

NUMBER OF PERSONS IN GROUP:  Leaders(kitchen staff excluded) _______  Campers _______  Total _______

DEPARTURE TIME FROM MAINLAND: ___________________________________________

DEPARTURE TIME FROM GRACE ISLAND: _______________________________________

I, the undersigned, agree and state as follows:

1.  This application is made on behalf of those who acknowledge Jesus Christ as Savior and Lord.
     and whose purpose is to honor God and extend his Kingdom.
2.  We fully agree to the published Statement of Faith of Grace Trust.
3.  Our efforts are not commercial or for profit.
4.  I have read and agree to abide by the rules and regulations of Grace Trust.

I, make this confirmation and sign this document believing the above to be true.



APPLICANT’S SIGNATURE: _____________________________________________________

Grace Trust reserves the right to grant or reject permission for the use of Grace Island facility based upon
the Statement of Faith and the purpose and principles of the Trust.