UAF RECREATIONAL CAMP SUMMER 2008

DATES
AM Session
PM Session
All Day
Before
Care
After
Care
Daily Care:
Before or After
Total

Week 1 July 7-11
$100
$100
$200
$20
$20
$5
$________
Week 2 July 14-18
$100
$100
$200
$20
$20
$5
$________
Week 3 July 21-25
$100
$100
$200
$20
$20
$5
$________
Week 4 July 28-August 1
$100
$100
$200
$20
$20
$5
$________
Week 5 August 4-8
$100
$100
$200
$20
$20
$5
$________
Week 6 August 11-15
$100
$100
$200
$20
$20
$5
$________

Camper's Name: ____________________________________________________Phone:__________________

Address: _________________________________________________________________________________

City/State: _____________________________________________________ Zip Code: __________________

T-SHIRT SIZE: YOUTH: 6 - 8 10-12     14-16      Adult :  SMALL       MEDIUM      LARGE       XL   XXLARGE

Grade entering in Fall 2008: ______________Age: __________   School: _____________________________

Emergency contact:_________________________________________________Phone:____________________

Insurance coverage by:_______________________________________________________________________

Policy number:_____________________________________________________________________________

Payment Method:  Cash        Check         Visa         MC

Account#:__________________________________________ Exp. Date _________________ V Code _____

Please charge a $50 deposit for each week ______ Please charge as paid in full at this time _____

Name appearing on card:_____________________________________________________________________

Signature of cardholder: ______________________________________________________________________

PRINT FORM, COMPLETE, AND MAIL or FAX (907-474-1998) WITH PAYMENT TO:
UAF Recreational Camp
University of Alaska Fairbanks
P.O. Box 757440
Fairbanks, AK 99775-7440
Ruth Olsen, Camp Director
(907) 474-6814
ruth.olsen@uaf.edu