Camp Forest 60 Payson Road ~ Brooks, ME ~ 04921 ~ (207) 722-3708 ~ 1-888-760-7943 Please print, complete and mail registration form. 2010 Expedition Registration Form Name: Age: DOB: Gender: Parent/Legal Guardian Name(s): Address: City: State: Zip: Home Phone: ( ) Work Phone: ( ) Email Address: Emergency Contact: Emergency Phone: ( )   Check Expedition Desired - $50.00 non-refundable deposit River Trip - July 12 - July 16  $500.00 Half Expedition - July 26 - July 30    $250.00 North Woods - August 9 - August 13   $600.00 Half Expedition - August 16 - 20    $250.00 Beaver Expedition - August 23 - August 27  $350.00 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!