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1999 CO-OP CAMP REGISTRATION

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NOTE: View this form with a fixed-space font like Courier if you want the columns to line up.

Call (510)595-0873 to reserve your space, or to get a work assignment, or if you have any questions. For Southern California inquiries call (626)796-4223. E-mail inquiries also welcome.

WEEK ONE: June 26-July 3

WEEK TWO: July 3-July 10

FAMILY NAME:

STREET:

CITY/STATE/ZIP:

PHONE/DAY:

PHONE/EVE:

FAX:

EMAIL:

Names appear on camp roster as listed here. We accept no applications for anyone under 18 unless accompanied by an adult sponsor - name and address to be on this form.

NOTE: REPEAT INFO BETWEEN ASTERISKS (CUT & PASTE) FOR EACH CAMPER IN YOUR FAMILY GROUP.

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FULL NAME:

AGE: []Y []N Do you prefer meatless meals?

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000 WK-1 BASE FEE (See B Below)

000 WK-2 BASE FEE (See B Below)

000 PREMIUM FEES (See C Below)

000 DAY FEES (See D Below)

000 PER DIEM FEES (See E Below)

000 CAMPERSHIP DONATION (See F Below) Thanks for your support!

000 EARLY PAYMENT DISCOUNT (See G Below)

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000 SUBTOTAL

000 CREDITS (Specify in H Below)

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000 TOTAL CAMPER FEE

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FAMILY FEE SUMMARY: TOTAL FEE NAME

--------- -----------------

000 Camper 1

000 Camper 2

000 Camper 3

000 Camper 4

000 Camper 5

000 Camper 6

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000 TOTAL FAMILY FEES

000 DEPOSIT ENCLOSED

000 BALANCE DUE

NOTE: MAKE A PRINTOUT OF THIS FORM AND MAIL COMPLETED APPLICATION WITH CHECK TO:

Co-op Camp

1442-A Walnut #415

Berkeley, CA 94709

(A) MEMBER DISCOUNTS

We need camper participation to make this year's camp a success. There is no fee to become a member, however 5 hrs of approved work are required. Each camper 11 years and older who pledges to work 5 hrs, qualifies for a $50 Member Discount.

[] Yes! Sign us up as 1999 Co-op Camp Members.

[] Call me/us to schedule work hours before camp.

[] Please assign my/our work hours when we register (hours to be completed at camp).

(B) CAMP FEE SCHEDULE

Adults Kids Kids Kids

Codes Accommodations   11 & older 8-10 3-7  Under 3
----- ---------------- ---------- ---- ---- -------

CP    Camping          368/318*   211  190  66

DM    Dorm             390/340*   222  200  66

CN    Cabin No Rstrm   395/345*   228  207  66

CW    Cabin w/Rstrm    411/361*   238  217  66

LD    Lodge            411/361*   238  217  66

DP    Duplex (min. 7)  417/367*   244  221  66

*Member Discount Rate applied (see A above)

PREFERRED UNIT: [First-come, first-served basis.]

C) PREMIUM CHARGES If your group is not large enough to fill a unit, add the following fees:

Cabin w/o restrm, less than 4 persons: ... add $15 ea.

Cabin, less than 6 persons: .............. add $15 ea.

Duplex, less than 7 persons: ............. add $15 ea.

Lodge, less than 4 persons: .............. add $15 ea.

(D) DAY FEES For conference & activities only

(no meals or lodging) - $20/day/person.

__ days x $20 = $___ per person

(enter in fee chart above)

Please mark which days you plan to attend:

[] 26 Sat [] 3 Sat

[] 27 Sun [] 4 Sun

[] 28 Mon [] 5 Mon

[] 29 Tue [] 6 Tue

[] 30 Wed [] 7 Wed

[] 1 Thu  [] 8 Thu

[] 2 Fri  [] 9 Fri

          [] 10 Sat

(E) PER DIEM FEES (Rates include meals and lodging.)

$70($59*) Adults 11 & up

$41 Kids 8-10

$35 Kids 3-7

$10 Under 3

*Discount rate ($59/day) applies to members only. No early payment discount on per diem fees.

Please mark which days you plan to attend:

[] 26 Sat [] 3 Sat

[] 27 Sun [] 4 Sun

[] 28 Mon [] 5 Mon

[] 29 Tue [] 6 Tue

[] 30 Wed [] 7 Wed

[] 1 Thu  [] 8 Thu

[] 2 Fri  [] 9 Fri

          [] 10 Sat

(F) CAMPERSHIP FUND (Voluntary)

Please add $3 or more per person for our campership fund. Your support will help make camp affordable for more first-time campers and families with large numbers of kids.

Thanks!

(G) EARLY PAYMENT DISCOUNT

Deduct ONLY IF PAID IN FULL by May 15.

Deduct: $20 Adult (11 and over)

$15 Child 6-10

$10 Child 3-5

$5  Child 2 and under
 

H) SPECIAL NEEDS

If anyone in your family has special needs or considerations, please attach a note explaining the situation.

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MAIL COMPLETED APPLICATION WITH CHECK TO:

Co-op Camp

1442-A Walnut #415

Berkeley, CA 94709

(510)595-0873

It's going to be a great year at Co-op Camp Sierra ...

SEE YA THERE!