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Camp Registration FormSUMMER CAMP 2008 REGISTRATION FORM Please mail completed form and $50 deposit to: Public Program Coordinator Please tick which camp(s) you would like to register for:
*An additional registration form will be sent upon receipt of this form. 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 Each camp registration must be accompanied by a $50 non-refundable deposit. Checks/Money Orders should be made payable to Eagle Bluff ELC. Visa Mastercard American Express (please circle) Card Number: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _ Exp. Date ____/____ Authorized Signature:___________________________________________________
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© 2006 Eagle Bluff Environmental Learning Center | All Rights Reserved |
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