Camp Forest 60 Payson Road ~ Brooks, ME ~ 04921 ~ (207) 722-3708 ~ 1-888-760-7943 Please print, complete and mail or your registration form. 2012 Camper Registration Form Camper Name: Age:      DOB:          Gender:     Parent/Legal Guardian Name(s): Address: City:        State:    Zip:      Home Phone: ( ) Work Phone: ( ) Email Address: Emergency Contact: Emergency Phone: ( ) Check Weeks Desired - $175.00 per week - $200.00 day camp with sleep over. June 25 - June 29        The Passy River Trip         $425.00 July 2 - July 6              Day Camp-   PARADE July 4  $175.00 July 9 - July 13            Day Camp-   Sleep Over July 12  $175.00   optional sleep over $25.00 July 16 - July 20            Day Camp-   $175.00 July 23 - July 27              EAGLE WEEK-   Sleep Over July 26  $200.00 July 30 - August 3            Day Camp-  $175.00 July 30 - August 3            North Woods: Family Expedition  1 Parent 1 child: $1,000; 2 Parents, 1 child: $1,500: additional child: $200 each August 6 - August 10         Day Camp-   Sleep Over August 9  $175.00    optional sleep over $25.00 August 13 - August 17        Day Camp-   $175.00 August 20 - August 24        Beaver Expedition-     $395.00 August 27 - August 31        Day Camp-     $175.00 Financial Assistance is avaiable. Is there anything physical, mental, or emotional about your child we should know? Is there anything in particular you would like us to know about your child? Is this the first time overnight camping? Tell us about any prior wilderness skills experience? Medical Information: Please bring a copy of child's up-to-date immunization record. Date of Last Tetanus Shot: ____________________ Does child have: ____Heart Trouble ____Epilepsy ____Asthma ____Allergies< Does child take medications regularly? ____Yes ____No If so, please list: _____________________________________________________________ Insurance Name:______________________________ Number:________________________ Doctor's Name: ____________________________ Telephone: __________________________ Please complete and mail with your $50.00 non-refundable registration fee. ____Check/Money Order Enclosed ____MC/Visa #___________________ Ex Date__________   Permission form will be mailed to you.   We look forward to seeing you at camp!