Wufoo

Application for Work Camps at the Joe Rush Center

Fill out this form to apply for the Work Camps at Joe Rush Center.

Group name *
Contact Name * First Last
Contact Phone * ### - ### - ####
Contact Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Email *
Dates requested *
Number of adult leaders (1 per 8-10 students) *

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.
Number of students *

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.
Please indicate the number of male and female participants. *
M= ?; F=?

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.

To make the deposit online, just click the PayPal button at www.urban-ministry.org.

Or you can mail the deposit to:

Urban Ministry Rush Center Work Camps
Attn.: Mike harper
1229 Cotton Ave. SW
Birmingham, Alabama 35211
Email
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