2008 Adult Opportunities Registration Form Please complete and mail with your registration fee. |
| Name: |
|
|
|
|
| Address: |
City: |
State: |
Zip: |
| Home Phone: ( ) |
Work Phone: ( ) |
|
| Email Address: |
| Emergency Contact: |
Emergency Phone: ( ) |
|
|
|
|
|
Saturday Workshops - $85 |
July 24: Simple Shelters
August 8: Wild Edibles and Medicinals
|
|
Medical Information: Insurance Name:______________________________ Number:________________________
Doctor's Name: ____________________________ Telephone: __________________________
|
____Check/Money Order Enclosed ____MC/Visa #___________________ Ex Date__________
| Confirmation and permission form will be mailed to you. |
See you at camp! |
|