Summer Camp '98 Registration Form

REGISTRATION FORM

Below is the actual registration form directly extracted from the Registration Packet.
Please fill it out and return to the address at the bottom. Make copies as needed.

WAIVER & REGISTRATION FORM
PLEASE COPY THIS PAGE OR FILL OUT A SEPARATE FORM FOR EACH ADULT ATTENDING.

I understand that Summer Camp will offer a large variety of activities that can be physically, mentally, or emotionally engaging. The level of my participation in any of the activities is at all times completely my choice. I may stop or say "no" at any time. In the event of an emergency I give the Summer Camp '98 Staff permission to call an ambulance or physician. I release Summer Camp Staff and NFNC from all liability for any injury to me from my participation in any of the activities. This release also applies to the minors listed below for whom I am responsible.

Days and Rates
Please check the days you plan to attend:

*Packages:*
	Tue 11^th-Sun 23^rd Both Weeks Before July 12: $463. After July 11: $540.	$____
	Tue 11^th-Tue 18^th 1st Week Only Before July 12: $360. After July 11: $420.
	Only for Campers who have been to NFNC Summer Camp before. Sun 16^th-Sun 23^rd 2nd Week Only Before July 12: $270. After July 11: $320.

- - OR - -

*Individual Days:* A 'day' runs from 7:00 PM to 7:00 PM.
Before July 12: $65. After July 11: $75.
	Tue 11^th-Wed 12^th Michael Aluna, Sharon Byrd	Rate: $_____ times Days: #_____ Total: $_____
	Wed 12^th-Thu 13^th Geoph Kozeny, Barbara Musser HAI
	Thu 13^th-Fri 14^th W&M Groups, Joseph Chilton Pearce
	Fri 14^th-Sat 15^th Talent Show / Auction, Mariana Caplan
	Sat 15^th-Sun 16^th Bruce Lipton, Closing Circle
There will be no drop-ins after the 16th.

Please Mail Check with this Registration Form to
SC'98, PO Box 160,
Forest Grove, OR 97116

Participant's Signature (if at least 18 years old):

___________________________________     __________
Name:                                                                Date
________________________________________________
Address:
________________________________________________
Cty, St, Zp:
________________________________________________

Home Tel. (_____) - ______________________________

Email: __________________________________________
Emergency Contact and phone:

___________________________ (_____) ____________
Minors' Names:
_______________________________ DoB: ___________

_______________________________          ___________

_______________________________          ___________
Parent/Guardian
Signature: _________________________      ___________
How did you hear about SC'98?                           Date
________________________________________________

Discounts: º Age < 8 are free. ° 1st Child over 7 free. º Register 2 other people: you get 35% off. º Register 3 other people: you get 70% off. º Register 4 other people: you come free.	Your registration $________ Less Discounts: $-________ Add'l Children aged 8-17: #____ at $15 each day or $90 for all: $________ Teen & Children 's Programs: $________
	Total Due: $________

A confirmation packet with your receipt, a map with directions, and last minute news will be mailed to all registrants. Shuttle service from PDX to Hillsboro airport is available. SC'98 will be running a shuttle service from the Hillsboro Airport to the camp site. The confirmation packet will contain our shuttle schedule and contact info, along with Camp phone numbers for emergency use. The packets will start going out right after the July 11th discount expires.