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Great decision!
Your kids are going to love camp! |
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Summer Camp Registration
Form 2010 |
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CAMPER INFORMATION |
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Camper's Last Name First Name |
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Home Address |
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City State
Zip |
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Date of Birth Male
Female .....No Gender Selected |
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SELECT SESSION |
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Register for Additional Weeks
Below if desired |
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ACTIVITY SELECTIONS (adventure camp & teen adventure camp only)
Customize your week of camp here by selecting in order of preference
your morning actvities 1-8.
Campers receive a total of 4 activity periods. Activities that
require 2 periods are noted. Activities are adjusted for age
appropriateness when necessary. Electives are offered each afternoon a` la cart
for campers who may not be able to fit all of their interests
into 4 activity periods. |
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Select Most Preferred |
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Activity Descriptions
Outdoor living:
compasses, geo caching, fire building, knots and fishing
Marksmanship: archery, air rifles, sling shots and ne!
Lake sports: canoeing, tubing or pontoon boat, fishing
and more.
Action Sports: mountain bikes, climbing tower, mountain
boards, rappelling!
Crafts: make crafts you can take home
Performing Arts: perform skits and mimes for your friends
at the evening fireside
Team Sports: soccer, basketball, flag football, volley
ball! |
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Select 2nd Choice |
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Select 3rd Choice |
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Select 4th Choice |
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Select 5th Choice |
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Select 6th Choice |
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Select 7th Choice |
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HORSEBACK RIDING (N/A for Horselover and Cowboy camps
and Whitewater Adventure)
No thanks. No Horseback Riding
YES, I would like to add a Trail
Ride (ages 8 and up) during the week. Include $20
to your camp fee.
Yes, I would like to add a Pony
Ride (ages 7 and younger) during the week. Include $10 to
your camp fee. |
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CABIN MATE REQUESTS
If your camper would like to be in the same cabin as his/ her
friend, please indicate their name here. Cabin Mates should be
no more than 2 years apart. To be honored, the cabin mate you
request here must also request you. Limit 2.
Cabin Mate 1
Cabin Mate 2 |
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PARENT GUARDIAN INFORMATION
Please list the parent or guardian who is responsible for enrolling
camper at Pleasant Hill Outdoor Center. |
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Name |
Home Phone |
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Cell Phone |
Emergency |
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E-Mail (for camp updates and information) |
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Address if different from camper
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City |
State Zip |
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FINANCIAL POLICY/ MEDIA RELEASE Must must be checked.
Yes, I understand that
my deposit is non refundable and is required to reserved space.
Additional fees paid are non refundable after June 1. I also
agree that Pleasant Hill Outdoor Center may photograph and or
video my camper while at camp for use in its promotional materials. |
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THIRD PARTY SPONSORS
If anyone other than the parent or guardian is sponsoring your
camper and has agreed to pay any portion of the camp fee, please
list their information below. If for any reason payment is not
made by the sponsor, the parent or guardian will be responsible. |
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Name |
Amount to be Paid $ |
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Address |
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City |
State Zip |
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Phone |
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Note: Please feel free to call our office with any questions
you may have or e-mail info@phoc.org
or director@phoc.org |
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PAYMENT METHOD (a minimum of $75 toward your camp fee is required
to reserve space) |
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Privacy Policy:
The information you share on this form is used only for the purpose
of facilitating your child's safe camp experience and for communication
with you our constituent. It is not sold to any other organization. |
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