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Cam mper Inf formatio on

Namee ________ __________


__________
__________
______ Agee ________
________
Addrress ______ __________
__________
_________
____________________________
City, State, Zip __________
_ __________
_________
____________________________

Parrent Info ormation n


Namee ________ __________
__________
__________
_________ __________ _________
Phone Number __________
_ _________
__________
_ Best Time to Call ___
_________
Emaill Address __
__________
_________
__________
_

Cammper’s Riding
R Exxperience
Do you ride at West
W Wind? Circle onee: YES NO
Describe your rid
ding experieence, if any: _________
_ __________
__________
_________
_
_______________________________________________________________________________
Do you have siblings attendinng? If so, who? _______
__________
_________
___________

ek Choic
Wee ces Pleasse check all the
t weeks you
y will be atttending
June 22 - 26 July 27 - 31
June 29 – July 3 August 10
1 - 14
July 6 - 10
0 August 17
1 – 21
July 13 - 17
1 August 24
2 - 28
July 20 - 24
2

Pay
yment Options
™ ___ weeks
w @ $425/week ____
__________
™ Familyy Discount ____
__________ office use
™ Multip
ple Week Discount ____
__________ office use
Depposit due at Registrationn - $100
Tottal ____
__________

Paym
ment Method
d: Cash/Cheeck # _____
___ Date __
_______ Appproved by: ______

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