Adult River Retreat Application

This will be for the 2013 Adult Burn Camp! Camp Dates are September 12th-17th, 2013. Cost is $500.00 per person. All information on this application form is necessary if we are to provide a safe, secure environment for you during the week of camp. You will not be accepted to Burn Camp unless every item of the application is filled out completely. Applications are reviewed by our Burn Center Medical Team prior to acceptance of your applications as this is a very remote wilderness type of trip.
* Required

Click "Continue" to go to the required Health Information form.