2014 Family Camp Registration

To register for Family Camp, please submit this form.
Please remit payment for the full fee.
Mail a check to: Family Camping/2230 N Clay Lick Rd, Nashville, IN 47448
OR provide credit/debit card payment below:

Confirmation of your registration and information about your arrival to camp, packing list and camp expectations will be sent to you via e-mail. For more information & questions contact Shelle Hertz, Camp Registrar at registrar@campranchoframasa.org OR 888.988.2839, x122.

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* 1. Please complete the following:

CONTACT PERSON

Mailing Address

City

State

Zip

Home Phone

Cell Phone

E-mail

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* 2. PARTICIPANTS
List first name, last name & date of birth for each person coming; please include the contact person from above.

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

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* 3. List any food allergies or special dietary needs for your family.

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* 4. List support needs for your family.

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* 5. List support needs for your family.

	yes	no
Would you like someone to contact you regarding your family's support needs?	Would you like someone to contact you regarding your family's support needs? yes	Would you like someone to contact you regarding your family's support needs? no

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* 6. Check your lodging preference.

	Yes
Gender Designated Cabin	Gender Designated Cabin Yes
Private Family Cabin ($75 additional for weekend)	Private Family Cabin ($75 additional for weekend) Yes
Campsite to “pitch a tent”---tents are not provided; bathrooms and showers are available	Campsite to “pitch a tent”---tents are not provided; bathrooms and showers are available Yes

PAYMENT
Family Camp Fees: $50 per child (under 18); $75 per adult OR $225 max per family (full weekend: Fri. 7:30p-Sun. 2pm) OR $30 per child (under 18); $55 per adult OR $130 max per family (Saturday only: 9am-10pm)

Personal checks, money orders, cash, and credit cards are all acceptable forms of payment. Cancellation: If your cancellation occurs more than 3 weeks before Family Camp, then fees are refundable less a $75 administrative fee. If your cancellation occurs less than 3 weeks before Family Camp, then all fees are non-refundable.

2014 Family Camp Registration

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* 1. Please complete the following:

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* 2. PARTICIPANTS
List first name, last name & date of birth for each person coming; please include the contact person from above.

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* 3. List any food allergies or special dietary needs for your family.

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* 4. List support needs for your family.

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* 5. List support needs for your family.

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* 6. Check your lodging preference.

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* 7. Account #

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* 8. Exp Date

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* 9. Amt to Charge $

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* 10. Print Name of Cardholder

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* 11. Electronic Signature (initial here):

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* 1. Please complete the following:

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* 2. PARTICIPANTSList first name, last name & date of birth for each person coming; please include the contact person from above.

Question Title

* 3. List any food allergies or special dietary needs for your family.

Question Title

* 4. List support needs for your family.

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* 5. List support needs for your family.

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* 6. Check your lodging preference.

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* 7. Account #

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* 8. Exp Date

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* 9. Amt to Charge $

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* 10. Print Name of Cardholder

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* 11. Electronic Signature (initial here):

* 2. PARTICIPANTS
List first name, last name & date of birth for each person coming; please include the contact person from above.