Name *

First Name

Last Name

Phone *

(###)

###

####

What days are you planning on attending? *

Friday

Saturday

Sunday

What meals will you be eating at camp? *

Friday Dinner

Saturday Breakfast

Saturday Lunch

Saturday Dinner

Sunday Breakfast

Sunday Lunch

What nights will you be staying? *

Friday night

Saturday night

None

What type of overnight accommodations do you need? *

Cabins can be assigned to one family/group OR you can be placed in a cabin with other weekend participants of the same gender.

Cabin for my family

Cabin with other participants of the same gender

Personal RV (hook-ups and space may be limited)

Not staying overnight

Waiver *

By checking this box I voluntarily waive any claim against Camp Elkanah, its sponsoring institution, 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. In consideration for the opportunity to participate in activity at Camp Elkanah the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity, as well as for any medical treatment rendered to the participant.

I agree