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

Resident Camp One (June 2-8) Boys: Girls:

Resident Camp Two (June 9-15 ) Boys: Girls:

Resident Camp Three (June 16-22) Boys: Girls:

Resident Camp Four (July 7-13) Boys: Girls:

Resident Camp Five (July 14-20) Boys: Girls:

Day Camp One (June 3-7) Boys: Girls:

Day Camp Two (June 10-14) Boys: Girls:

Day Camp Three (June 17-21) Boys: Girls:

Day Camp Four (July 8-12) Boys: Girls:

Day Camp Five (July 15-19) Boys: Girls:

Canoe Camp (July 1-7) Boys: Girls:

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