EmailMe Form - CREC Summer Camp 2013

First Name *
Last Name *
Address *
Address (Line 2)
City *
Postal Code *
Phone Number *
Parents Name and Phone # *
Emergency Contact and Phone *
July 15-19 *
Aug 12-16 *
Helmet Rental *
Allergies *
Camper's Experience Level *
Comments
Payment
$75.00 Deposit required to hold your spot. Balance due the first day of camp. Please send your cheque or drop into the farm with your deposit. On-line form will temporarily reserve your spot until the deposit has been paid.