Camp Registration Form

SUMMER CAMP 2010 REGISTRATION FORM
Questions can be directed to: 507-467-2437, 888-800-9558,
or camps@eagle-bluff.org

Please mail completed form and $50 deposit to:

Public Program Coordinator
Eagle Bluff ELC
28097 Goodview Drive
Lanesboro, MN 55949

Please tick which camp(s) you would like to register for:

_____ Paddlers Camp (June 27-30, 2010)

_____ Night Camp (July 11-14, 2010)

_____ Forkhorn Camp (July 18-23, 2010)

_____ State Park Excursion: Whitewater (July 25-28, 2010)

_____ Water Adventure Camp (August 1-4, 2010)

Participant Name: _________________________________________

Date of Birth: ______________  Age: ________  Gender: _________

Parent/Guardian: __________________________________________

Address: _________________________________________________

City: ______________________  State: _______ Zip: ____________

Day Phone: _________________ Eve. Phone: __________________

Email: ___________________________________________________

Sponsoring Organization (if applicable): ________________________

T-Shirt Size (please circle):   Youth Medium        Youth Large       
Adult Small       Adult Medium       Adult Large       Adult XL

Each camp registration must be accompanied by a
$50 non-refundable deposit.

Checks/Money Orders should be made payable to Eagle Bluff ELC.

Card Number: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _   Exp. Date ____/____

Authorized Signature:___________________________________________________