AutoSub Camp Survey 2013
Welcome AutoSub Campers!

Please fill out the form below as soon and as completely as possible.  While we hope we don't need some of this info, it's important to have just in case.

Emergency contact info will be seen only by Damon H and the Safety Pod Leader (Adam B)

Food preference/allergy info will be shared with the kitchen.
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Personal Info
Full (legal) Name *
confidential if you want it to be
Playa Name
What do you prefer to be called in camp?
Best Email Address *
Best Phone Number *
Preferrably a Cellphone
Street Address *
Emergency Info
In the event something happens and you're unresponsive.
Emergency Contact (Someone NOT on Playa) *
Name, Email, Phone Number, and Relationship
Known Allergies *
NA if none
Prescribed Medications Taken at Burning Man *
NA if Not Applicable
Please list any medical conditions we should be aware of *
Is your tetanus booster up to date? *
Kitchen/Food
Removed from this survey: Please fill out the kitchen survey that Tish has distributed.  It should be located here:  https://docs.google.com/spreadsheet/ccc?key=0Arx0RixGMjKOdFh0dHZjMjdXWGYxaGM0YjVfWGRqVmc#gid=0
Camp
What's your part of camp going to look like?
Please describe your dwelling *
Tent, yurt, RV, etc
Anticipated total footprint? *
Include guywires, sprawl, etc
Will you be sharing this with another camp member? *
To make sure we don't double count things.
Art
Are you bringing art to the playa? *
If YES, where do you anticipate/want it placed?
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