Wufoo
Camper Registration
Camp Quest of Michigan 2009 C.E.
Arrive Monday August 17 after 12pm Noon
Depart Sunday August 23 before 3pm
Camper Name
*
First
Last
Parent/Guardian Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Email
*
Phone Number
*
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Camp Fees:
Camper: $550 per camper, $500 for siblings ($475 per camper/ $425 for siblings if enrolled by April 30).
NOTE: The fee includes everything (except for some elective activities that may be offered by the 4-H at our camp facility for which incidental fees are collected)
T-shirts: This year, one T-shirt and one cap are included in the camp fee. Additional shirts are available $10 (each); indicate size(s) for shirt(s) desired
Chilld 7-8
Child 10-12
Child 14-16
Adult SM
Adult M
Adlut L
Adult XL
Adult 2XL
Camp Photo: The fees include one camp photo for each camper; additional copies are $6 each
Elective Activities: (To be determined - details will be provided later)
Registration fee of $100 must accompany application (Except for early enrollment offer). (This fee will be deducted from total fee and is non-refundable after July 31, 2009.) Balance of all fees is due by July 31, 2009 (we have to pay to rent the camp facility) Please pay by check or click the PayPal button on our opening page.
Make checks payable to “Camp Quest of Michigan”
Please include a recent photograph of the camper.
Please include any special instructions below.
Do Not Fill This Out