REGISTRATION FORM
Camp DoReMi 2017  *  August 17-20, 2017
Wildacres Retreat  *  Little Switzerland, North Carolina

Please print this form and fill out separate forms for each registrant. Make check payable to Camp DoReMi.
Mail form and payment to Jane Cannon, Camp DoReMi, PO Box 15, Chimney Rock NC 28720.

                                                                     Name:

                                                                     Address:

                                                                     Age:                     Gender:                                 Phone#:                                                  E-mail:

                                                                     Emergency Contact (include name & phone #):

                                                                     Name of Parent or Guardian that will accompany this participant if under 18:

                                                                    ______ Full Participant - $285 - Includes double occupancy with bath at Wildacres Retreat  for three nights, 8 meals, gratuities and classes  (NO LONGER AVAILABLE)
     
                                                                    ______ Commuter - $60 / day - Includes classes and 3 meals per day.  


                                                                  Roommate Preference (if you do not specify, one of your gender will be assigned for you):


                                                                 Camp Mailing List: Would you like your e-mail address to be included in a list of participants available only to Camp DoReMi?

                                                                 Books you will bring to Camp:  (Circle the ones you'll bring)   The Christian Harmony, 2010 Ed.      The New Harp of Columbia


                                                                  SPECIAL NEEDS: (for example, difficulty climbing stairs or dietary restrictions)