21395 Milsa, San Antonio, Texas 78256

(210) 564-6400

Registration Form

Session 1: June 16-20, 2008 OR _ Session 2: June 23-June 27, 2008

Participant: Name:______________________________________ Age at Camp time:_______

Participant: Address: _________________________________________________________

City: ______________________________ State : ______ Zip: ____________

Phone: ______________________________

Mother: Name: __________________________

Work #: _______________ Home #: ______________ Cell # ____________

Father: Name: __________________________

Work #: _______________ Home #: ______________ Cell #: ____________

Enclosed is $85 to reserve my child’s place. (Checks should be made payable to Friends

of Friedrich Wilderness Park.) I understand that registration is on a first come, first served basis, and is only considered complete when I have received a written confirmation letter. I also understand that no refunds can be made after June 9, 2008, unless an alternate person from the

waiting list fills the space.

Signature: ________________________________ Date_____________________________

Medical

Does the camper have any allergies (insects, plants including hay fever, food, medications) or medical conditions of which the camp staff need to be aware? ____ Yes ____ No

If yes, please explain:_____________________________________________________________

_____________________________________________________________________________

FOR OFFICE USE ONLY

Date Received:______________________

Indemnification Form Completed: Yes No

Release for photographs Form Completed: Yes No

Medical Information Form Completed: Yes No