Vision Quest Registration 2020
Please fill out one form per family to attend this year's vision quest camp
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July 5 - 10, 2020
Registration Due June 1, 2020

Adult/Elders Name *
Young Adults / Children’s Name(s): Ages: *
please enter NONE if no children or young adults
Address
Phone Number *
Email Address *
When will you arrive at camp *
Do you have any preexisting health conditions, disabilities, or special needs we should be aware of?  No   Yes (if so please explain): *
Emergency Contact Name and Phone Number *
Do you have any Dietary Restrictions
Clear selection
If you selected Other please list dietary restrictions here as well as any food allergies or sensitivities?  
Payment
Adult (21+) =  $285
Elder (65+) and Young Adult (16-20) =  $250
Children (0-15) Free

We are offering a 3 month payment plan for those that can't pay full amount at once -
Payment 1 Deposit $75.00USD.
Payment 2 After 4 week(s) $110.00USD (88.50 Elder & Young Adult)
Payment 3 After 7 week(s) $110.00USD (88.50 Elder & Young Adult)
Total $285.00USD

Daily Rate - $60 Adult / $50 Elder and Young Adult

Please go to this link for payment  - https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=AQJRRMZLAYT3G


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