Wild Women's Week - June 25-July 2, 2021

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Camper Registration - $600.00 per person. $100.00 nonrefundable deposit due May 15, 2021.

Email *

Name *

Camper Date of Birth *

YYYY

Address *

Phone *

Emergency Contact Name and Relationship *

Emergency Contact Phone *

If you are registering with another woman who you will share a room with, someone from your "household" or "bubble", please share their name here.

Please list any medical conditions the staff at Sly Brook Adventures and Lugdon Lodge should be aware of and any modifications you may require. We will do everything we can to provide them.

Please list any allergies the staff of Sly Brook Adventures and Lugdon Lodge should be aware of; What are the symptoms and what are the typical treatments.

By entering my name below: *

I give Sly Brook Adventures and Lugdon Lodge permission to use any photographs, videos or interviews of me to promote and advertise Sly Brook Adventures, Lugdon Lodge and their activities.

I acknowledge that all deposits and payments are non-refundable.

I understand that the Directors of Sly Brook Adventures and Lugdon Lodge reserve the right to ask me to leave an activity or area due to nonconformance to camp rules or due to illness.

I understand the Directors of Sly Brook Adventures and Lugdon Lodge reserve the right to seek outside medical attention and to hospitalize me. All medical expenses will be paid by me or my insurance.

I understand the use of alcohol shall be minimal and reserved for my cabin or specific events.

I understand the use of tobacco, marijuana and illegal substances are not allowed on the Sly Brook Adventures and Lugdon Lodge property.

PLEASE TYPE YOUR NAME AND DATE IN THE "OTHER" LINE as form of signature

Other:

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms