Family Camp 2017 Registration Form

Family Name: ______

Person Name Birthday Adult #1

Adult #2

Child #1 (Under 18)

Child #2 (Under 18)

Child #3 (Under 18)

Child #4 (Under 18

Child #5 (Under 18)

Child #6 (Under 18)

Please list additional persons above the 2 adult, 6 children maximum .

Street Address: ______City: ______

Province: ______Country: ______Postal Code: ______

Primary Email Address: ______

Phone Number (Home): ______(Cell): ______

Accommodation Information

Circle/highlight the week(s) you are registering for:

Week 1: July 29-August 5 Week 2: August 5-12

Week 3: August 12-19 Week 4: August 19-26 Type Accommodation Weekly Record the Cabin Name/ Room #/ Rate Campsite # requested below: Chalet Beechwood, Cedar Rest, As $1323 u Like it, City Hall Ahmic View Daybreak, Eventide, Midday, $891 Sunset The Lodge Upper level (air conditioned) $605 The Lodge Lower level walkout $691 Pine Cabins Wyldewood, Porcupine $567 Ridge, Deer Run Full Service Cabin Maplecroft $810 Full Service Cabin Birchmere Woods/Lodge $729 Full Service Cabin Linger Long $621 Rustic Cabins Little Lookout Old Tuck, $513 Retreat Up, Retreat Lodge, Retreat Woods

Campsite With electricity $340 Campsite Without electricity $302

Optional Items

# of Boat Docks Needed ($60/dock/week): ______

# of Adult (Age 12 and older) All-Inclusive Meal Plans ($170/week): ______

# of Child (Age 5-11) All-Inclusive Meal Plans ($85/week): ______

# of Adults (12+) for Saturday Arrival Supper ($10): ______

# of Children (5-11) for Saturday Arrival Supper ($6): ______

New Registration/Cancellation Policies Please read and sign below.

 Accommodation prices are based on a maximum group of 2 adults and 6 children (under 18). Additional persons will be charged $5/day/person  All fees do not include HST  Each accommodation is subject to a $25 General Facility Fee per week which will be applied by the office to each registration  Accommodations can only be booked for a full week until 4 weeks prior to the camp start date. At this time, shorter stays can be arranged at the time of booking only. Campers who registered for a full week will not be refunded the difference if they leave early.  If a cancellation is necessary between September 30th 2016 and June 15th 2017 the following options exist: o The 20% deposit is deferred to a future time with no site guarantee. Payments made beyond the 20% will be refunded. o The 20% deposit is refunded less a $25 cancellation fee. Payments made beyond the 20% will be refunded. o All payments made will be donated to the Camper Assistance Fund with a donation receipt  If a cancellation is necessary between June 15th 2017 and two weeks prior to your arrival date the following options exist: o The 20% deposit becomes non-refundable and cannot be deferred. Payments made beyond the 20% are deferred to a future time with no site guarantee. o The 20% deposit becomes non-refundable. Payments made beyond the 20% are refunded less a $25 cancellation fee.  If a cancellation is necessary less than two weeks prior to your arrival date all payments made become non-refundable and cannot be deferred. If the cancellation is a result of a medical emergency or the death of a close family member, a refund will be issued at the discretion of the Director.

I have read and understand the policies listed above: ______

Payment Options

Check which applies.

______I wish to pay in full at this time.

______Please bill my credit card now for the 20% deposit only.

______Please bill my credit card now for the 20% deposit and then in 3 equal installments between now and my camp start date. Dates may vary depending on registration date.

______I will mail in a cheque for my deposit.

Credit Card Information:

Name as it appears on card: ______

Credit Card Number: ______

Expiry Date (month/year): ______CVV Code: ______

Signature: ______