Highland Lakes Camp & Conference Center

 “Ring the Bell”

Order Form

Person Placing Order:       Church Title 

Phone Number to Confirm Order           ()

E-mail to Confirm Order           

Mail Coin Holders to:     Attention:         

                                    Church Name   

                                    Address           

                                    City                  Zip

Number of Coin Holders Ordered Delivery on or before //

To allow time to process and ship the order, requests for coin holders should be made 3 weeks prior to the event.

VBS or Day Camp Dates: Times of the Event

Requesting a Camp Representative       

(a)    To make a presentation      Yes Date Time

            Any special requests for the presentation

(b)    If you are having an end of the week “recognition service,” would you like a representative?

Yes No If “yes”-what day and time

To download a  PDF file to fill out and mail in click here

Mail To:                                                Attention:          Rod Cordsen   

                                                Highland Lakes Camp & Conference Center

                                                5902 Pace Bend Rd. N.

                                                Spicewood, TX 78669

Contact:  Rod Cordsen     -Cell (512) 934-0252   HLCC Office-  (888) 222-3482   Fax 512-264-2794