2008 Yellowstone Alliance Adventures Camp Registration!
Items marked with an asterisk (*) are required.  (Instructions below)

* Camper Name (Last, First, Middle Initial):     Nickname: 

* Male    * Female   * Birth Date:  Age:  Grade - Fall 2008: 

NOTE: All camps are coed. 

* Camper’s Street Address: 

* City:  * State:   * Zip: 

* Phone: Home:  Cell: * E-Mail: 

* Parents/Guardians Names:     Relationship: 

    Daytime Phone 1:  Daytime Phone 2: 

    Church where you attend: 

    Address:     City:      State:      Zip: 

    Has the camper attended a Yellowstone Alliance Adventures camp before? 
    Yes   No   Year(s) attended:   Name siblings(s) attending in 2008:

    How did you hear about Yellowstone Alliance Adventures?  Check all that apply:
   Church   Friend  Internet  Radio  Returning Camper  Other  

Cabin Buddy Choices: (We will TRY to put you with at least one buddy.)
    Buddy #1: Buddy #2:

Medical information  * Insurance Co: * Policy #: 

* Date of last tetanus immunization: 

* Is the camper subject to: None Seizure Asthma Allergies Bed Wetting Other
    Description: 

* Is your camper allergic to any medications?     Yes    No 
    If so, Which ones?: 

* Is your camper bringing any medications?     Yes    No 
    If so, Which ones?: 
    Please use another sheet of paper to describe and be sure to give concise instructions concerning all information above.

I hereby verify that all immunizations are up to date, and the above information is completed and accurate to my knowledge. I hereby grant permission for my child to receive first aid and emergency treatment by the camp nurse and or camp staff in the event of illness or injury, or by the hospital emergency room in case I cannot be reached immediately. I voluntarily waive any claim against Yellowstone Alliance Adventures, camp personnel, or other person(s) transporting my child against all liability, claims, damages, attorney fees, expenses arising out of or in connection with any activities of the above organization. I agree to notify the camp of any changes prior to camp session.

     __________________________________________________________________ Date: _______________
                                    Signature of Parent/Guardian

 

Camp Rate:

Amount to be Enclosed:

 Camp Rate of selected camp

*Registration Fee:

 *Activity Fee (noted with camp selection)

*Activity Fee:

 Total Camp Rate

Additional Donation to Camp: <>

 Discount:

Other: <>

 Less Registration and Activity Fees Enclosed

**Total Amount Enclosed: 

 Plus Late Fee - $15.00

Due if registration is sent less than 14 days before camp starts.

 Plus Camper Store Cash
 Amount Due upon arrival

For Office Use
Date Received:__________       Amount Rec:__________
Check/M.O. #:__________       Amount Due:__________




The medical history of the camper must be completed and signed before registration can be completed and the camper can attend camp.

**Registration will be valid only after payment is received.
*These non-refundable, non-transferable registration and activity fees MUST BE PAID in full before your registration will be processed.

 

 

Registration Instructions

1. Complete all requested information.
2. Select camp and enter fees into camp rates, then total.
3. Enter the appropriate fees and donations, then total.
4. Calculate the remaining balance due by subtracting fees from total camp rate.
5. Check "Print Preview" before printing and adjust it if necessary to print the form on one page.
6. Print, sign form, and enclose check or money order for the "Total Amount Enclosed."
7. Mail completed registration form with a check or money order to:

Yellowstone Alliance Adventures • 13707 Cottonwood Canyon Rd. • Bozeman, MT 59718
Phone: 406.763.4727 • Fax: 406.763.4727