Camp ANV 2017 HoliDay Registration Form
Camp ANV Camper Application / ANV Aplicación de Campamento

Session Dates:
Fall HoliDay Camp - November 20-22 (M-W)
Winter HoliDay Camp Session I - December 26-29 (T-F)
Winter HoliDay Camp Session II January 2-5 (T-F)

Address: Tassafaronga Recreation Center
975 85th Ave. Oakland, CA 94621

One Application Per Family. $50 per child, per week of camp./ Una aplicación por familia. $50 por niño/a, por semana

Contact Camp ANV at (510)838-CAMP (2267) or CampANV@anvfarm.org

Email address *
Number of Campers *
Camp ANV 2017 HoliDay Registration Form
You can register up to three campers on this form. / Puedes registrar hasta tres campistas en este formulario.
Please continue through all sections in order to submit registration. / Por favor, continúa a través de todas las secciones para enviar el registro.
Parent or Legal Guardian Contact Information/ Información de Contacto del Padre o Tutor Legal
*Indicates Response Required/*Indica que respuesta es necesaria
Parent's FIRST and LAST Name / Nombre y Apellido: *
Ex: Kelly Carlisle
Your answer
Phone/Teléfono: *
Your answer
*Address/ Dirección, City/Ciudad, State/Estado, Zip Code/Codigo Postal: *
Ex: 1001 83rd Ave. Mailbox #1 Oakland, CA 94621
Your answer
*Registration for which camp? / ¿Registro para cual campamento? *
Required
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