Registration Form for New Culture Summer Camp - Central Oregon, August 17-26, 2012
Welcome to the Summer Camp - Central Oregon Registration form! We're looking forward to seeing you in August!

This form has six pages of questions: Your Information, Children's Program, Co-Creation, Indoor Accommodations, Lost Valley Residents' Information, and Summer Camp Fees. Information about Pre-Camp (August 14-17) and Post-Camp (August 26-29) is given on the Co-Creation page. If you have any questions or difficulties while filling out the form, please do not hesitate to contact us at sc12co@cfnc.us or 800-763-8136! The FAQ page at http://scco.cfnc.us/faq.html may also be helpful.

If you find that you cannot progress to the next page of the questionnaire, please review the registration form to make sure that you have given an answer for all mandatory questions. (Questions marked by an asterisk (*) are mandatory. ) Also, please make sure that you get to the "Thank you!" page at the end of the form - if you don't see that page, your registration has not been completed. If you submit your registration and still do not see that page, review the registration form to make sure that you have given an answer for all mandatory questions.

Please be aware that all attendees of Summer Camp must pre-register - we do not take walk-in campers.

YOUR INFORMATION
Please enter your contact information:
First Name *
Your answer
Last Name *
Your answer
Preferred name, if different from above - enter N/A if not applicable *
Your answer
Email *
Your answer
Cell Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Home Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Work Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Street Address *
Your answer
City *
Your answer
State or Territory *
Your answer
Zip *
Your answer
Country *
Your answer
We will be making a contact sheet for event participants -- what contact information would you like included on the sheet? *
Yes
No
N/A
First Name
Last Name
Preferred name (if applicable)
Email
Cell Phone
Home Phone
Work Phone
Street Address
City
State or Territory
Zip
Country
Photo (Will be taken at camp)
Please give us a person to contact in case of emergency, preferably someone who is not also attending camp
Name *
Your answer
Cell Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Home Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Work Phone - use format XXX-XXX-XXXX - enter N/A if not applicable *
Your answer
Relationship to you *
Your answer
Are you 18 or older? People 17 or younger need to bring an adult parent or guardian. *
Optional: enter your age here. (It can be helpful to us to know the ages of attendees.)
Your answer
Have you been to previous New Culture events? *
Required
How did you hear about this event? *
Required
What inspires you to attend this event? What are you looking to give and receive at the event? (This is an optional question, and we welcome both short and long answers.)
Your answer
Each year, we set up an email discussion list before camp so that attendees can get to know each other, share resources, and start building community before camp. It also serves as a great way to connect and debrief after camp.
Normally we subscribe all registrants to the Summer Camp email discussion list, sc12-co@yahoogroups.com. You can of course unsubscribe at any time. *
If you would like us to subscribe you under an alternate email address from the one you entered above, please enter it here.
Your answer
Arrival at Camp:
In order to build an intimate community with a strong sense of safety, it is essential that everyone be in place for the start of orientation at 9:00 AM on Saturday. We ask everyone to arrive on Friday evening if at all possible, and if not, by 8:30 AM on Saturday mornng at the latest. Late arrivals are not allowed except in extraordinary circumstances.
When do you plan to arrive? *
Departure from Camp:
If you can't stay for the entire time, camp can still be a powerful experience. If you must leave early, we understand, and appreciate the time that you could spend with us.
Do you need to leave early? *
If so, what day?
Your answer
Do you need or can you offer a carpool? (Please post on the Facebook event page, https://www.facebook.com/events/244557365656986/, to set this up.) *
If so, from where?
Your answer
Do you have any special needs or medical/psychological issues the organizers should know about? (This information will be kept confidential to the organizers) *
If so, please give details:
Your answer
Meals will be delicious, healthy, vegetarian food with a vegan option. With enough advance notice, we can also accommodate many special food needs. In addition, there is space for people to store personal food, and a small kitchen where those with special diets can prepare what they need.

Please check the items below that are true for you. *
Required
If you find that you cannot progress to the next page of the questionnaire, please review the registration form to make sure that you have given an answer for all mandatory questions. (Questions marked by an asterisk (*) are mandatory. )
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