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Primary Application for Camp Robin Rogers Resident Camp 546 S. Collett Street, Lima, Ohio 45805 (419) 225-6285 Campers Full Name LAST FIRST MIDDLE DATE OF BIRTH MAILING ADDRESS CITY STATE ZIP SEX MOTHERS NAME HOME PHONE WORK PHONE FATHERS NAME HOME PHONE WORK PHONE CAMPER LIVES WITH: FATHER MOTHER GUARDIAN Child must be 8 years of age on or before June 1, 2005. Resident Camp will run from Sunday, August 7, 2005 through Wednesday, August 10, 2005. Sign-in will be from 6:00 p.m. to 7:00 p.m. on Sunday evening at the camp. We will have a Family Picnic at the close of camp on Wednesday, August 10th from 5:00 p.m. to 7:00 p.m. All family members are welcome. Resident Camp Fee: For 3 nights and 3 days: $300.00 (this fee must be paid by July 1, 2005) A Non-Refundable Registration fee of $25.00 must accompany this application. Upon receipt of this application, additional paperwork will be sent to you. (reservation confirmed with paid fee) Space is limited and will be on a first-come, first-served basis with deposit. ***There will be no transportation available for Resident Camp*** Camp T-Shirts are available for $10.00 each. Order& PAYMENT must accompany this application. (same as Day Camp T-Shirts) Medium Child Large Child / Small Adult Medium Adult Large Adult x Large Adult DEADLINE FOR THIS APPLICATION IS: JUNE 1, 2005
"Application for Camp Robin Rogers"