Group Hold Information Form

Group Hold Information Form (groups registering for any summer camp program)
FORM MUST BE FILLED OUT COMPLETELY

Organization/Group Name:

Organization Street Address:

Organization City:

Organization State:

Organization ZIP code:

Organization Phone Number:

Organization Email:

Primary Contact or Group Coordinator:

Primary Contact Street Address:

Primary Contact City:

Primary Contact State:

Primary Contact ZIP code:

Primary Contact Phone Number:

Primary Contact Email:

Billing Contact (if different from Primary Contact):

Billing Contact Street Address:

Billing Contact City:

Billing Contact State:

Billing Contact ZIP code:

Billing Contact Phone Number:

Billing Contact Email:

Amount organization is paying, if any: (please write n/a if not applicable)

REQUIRED:

Indicate the number of boys and girls you want us to hold spots for in each of the following:
ONLY FILL IN FOR EACH WEEK YOU NEED SPOTS

Overnight Camp One (June 7-13) Boys: Girls:

Overnight Camp Two (June 14-20) Boys: Girls:

Overnight Camp Three (June 21-27) Boys: Girls:

Overnight Camp Four (July 5-11) Boys: Girls:

Overnight Camp Five (July 12-18) Boys: Girls:

Day Camp One (June 8-12) Boys: Girls:

Day Camp Two (June 15-19) Boys: Girls:

Day Camp Three (June 22-26) Boys: Girls:

Day Camp Four (July 6-10) Boys: Girls:

Day Camp Five (July 13-17) Boys: Girls:

Canoe Camp (June 28-July 4) Boys: Girls:

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