Cascade Camp Cherith Registration Form

2017 Camper Registration Form One camper per form. Please complete this form in Microsoft Word, print, sign, and mail by June 15 with payment to: Cascade Camp Cedarbrook  Jayne Blackburn, Registrar 13311 3rd Ave SW  Burien WA 98146

Name Phone Sex Grade in fall M F Address City State Zip

Cabinmate preference. (Must be same grade.) Camper Birthday Camper Age

Parent(s)/Guardian with whom camper lives Parent’s e-mail address

Church camper attends

Early payment discount: if payment in full is postmarked by April 30, deduct $30.00 from *full week camp fee. Classic Camp Cost Boys Camp July 9 – 15 *$420 Girls Camp July 16 – 22 *$420 Girls Camp July 23 – 29 *$420 Voyager Camp Voyager Boys Camp July 9 – 11 $150 Voyager Girls Camp July 23 – 25 $150 Horse Specialty Camp Girls HSC July 9 – 15 *$645 CILT Boys Camp with CILT I July 9 – 15, plus one spring weekend *$505 Boys Camp with CILT II July 9 – 15, plus one spring weekend *$420 Girls Camp with CILT I July 16 – 22 and July 23 – 29 *$690 Girls Camp with CILT II July 16 – 22 and July 23 – 29 *$520 Horsemanship Activity per week Available for boys and girls during Classic Camps $110 Outposting Specialty Weekend (Included in Girls CILT I and II costs) $95 Your camp fee includes a T-shirt and a camp picture. Please Camper T-shirt size indicate T-shirt size. Sizes may not be available after June 1. Youth M L Adult S M L XL XXL If total camp fee is not enclosed, a $50 non-refundable deposit is due with *Early payment discount – registration. Registration form and the ENTIRE fee is due by June 15, unless Discounts applicable ONLY if payment in special arrangements have been made with the camp registrar. After June 15, full is postmarked by discount due date. a $40 late registration fee will be assessed. Please review our refund policy, found on the Forms page of our camp Late registration fee website. Total enclosed $ Note: $25 NSF check fee.

Camper registrations are accepted in the Charge: VISA MC # Exp Date CVV order received, regardless of race, color or national origin. Upon receipt, Signature Date additional information will be sent to you. Make checks payable to: Cascade Camp Cedarbrook

Permission Agreement Horsemanship Class and Trail Rides Waiver Cascade Camp Cedarbrook has my The undersigned has sent a child or children to Cascade Camp permission for my child to attend camp, to Cedarbrook, a non-profit Washington Corporation, to participate in the participate in its activities, and to receive horsemanship program. Said parents or guardians understand that the emergency treatment, if necessary. He/she program has some inherent risks and do hereby release Cascade may be photographed and pictures may be Camp Cedarbrook and all of its staff and agents from any claims for used for camp promotion. injuries to or death of minor children involved in said horsemanship program, and the undersigned agrees to hold harmless Cascade Camp Cedarbrook and its staff and agents from any claim by any child injured in said program. Parent/Guardian Date