You will receive an confirmation within 48 hours that your applcation has been received.  Once you have submitted your application, please mail your $135 registration fee to Curtis Ward, 1317 D FM 1614, Rotan, TX, 79546.  For a map to Camp Butman, please visit our Links page!
Encounter Dates:
First Name:
Last Name:
Email:
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Date of Birth:
Age:
Sex:
Occupation:
Church Affiliation:
Special Medications:
Health/Physical Limitations:
Do you snore:
Sponsor Name:
Emergency Contact Name:
Emergency Contact Phone: