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Choose Your Summer Session
 Session A: Monday (1pm) Aug 6 - Aug 12 Session B: Monday (1pm) Aug 13 - Aug 19

Returning Campers:
How many years have you been joining us?
First Time Campers:
How did you hear about us?
What schools do your children attend?
All Campers:

Please fill in all required fields. Required fields are specified or indicated with a *.

Family Contact Information: (all fields except cell phone are required)
Name Email
We will email a copy of this registration form to the email address above
Address City
State Zip Home phone Cell phone

Enter the name and birthdate of the campers in your party
Name Birthdate: MM/DD/YY (required)
Name Birthdate: MM/DD/YY
Name Birthdate: MM/DD/YY
Name Birthdate: MM/DD/YY
Name Birthdate: MM/DD/YY
Name Birthdate: MM/DD/YY

Please note: Minors (under 18) attending camp with adults other than their legal parent/guardian must complete a Guardian Permission Form. See our website www.cazfamilycamp.org to obtain the form.

Emergency Contact Information (optional):
Name Email
Address City
State Zip Home phone Cell phone

Special meal requests and food allergies, please fill in your information, leave blank if none.

Name  Vegetarian No Dairy No Red Meat
Allergies

Name  Vegetarian No Dairy No Red Meat
Allergies

Name  Vegetarian No Dairy No Red Meat
Allergies

Name  Vegetarian No Dairy No Red Meat
Allergies

Additional Information:


CAMPER FEES (Camper fees are based on ages as of the first day of each session.)

There is a $ non-refundable registration fee. (Goes to $100 after May 1)

Enter # of Adults (19+) $/pp
Enter # of campers Ages 6-18 $/pp
Enter # of campers Ages 3-5 & SENIORS (over 65) $/pp
Enter # of campers Ages 2 & Under (no charge)

HOUSING OPTIONS : SELECT AN OPTION FROM BELOW (required)
Tent cabins and dorm rooms available on a first come, first served basis.

You are a group of 4 or 5 and request a tent cabin if available (no extra fee)
You are a group of 3 or less and request a tent cabin. Additional $360.00
You have 6 or more people in one tent cabin. 10% off
Your group will be sharing a tent cabin with another family. Each family must have 2 or more. 10% off
---- Enter other family name here
Your group will bring and sleep in a tent, an RV, or a car. 10% off
You have 2-3 in your group and you would like a dorm room (no extra fee)
---- If no dorm room is available then I will
----  Share tent cabin with another small group Stay in tent cabin with only your group ($360 fee added if necessary)

DONATIONS
$ Please consider a tax-deductible donation to the Family Camp Scholarship Fund
$ Please consider a tax-deductible donation to the Lanier Pruitt Diversity Fund

Calculate your payments to see totals.
If you change camper numbers, housing option, or donations, then you must click to recalculate.

$ TOTAL CAMPER COST -- Breakdown $ adults $ youth $ Junior and Senior
$ WITH REGISTRATION FEE

Your Housing Option --

$ WITH HOUSING ADJUSTMENTS ( surcharge multiplier )

$ TOTAL PAYMENT DUE INCLUDING DONATIONS

MINIMUM INITIAL DEPOSIT DUE WITH REGISTRATION FORM*
Amount: $ (Includes registration fee and $100 per camper)

BALANCE DUE BY JUNE 1, $

PAYMENT TIMELINE and METHOD *
 I will pay for our total fees IN FULL now I will pay the deposit and the balance in two more installments April 1 and June 1

PAYMENT METHOD *
 I am mailing a check. I will pay online.
If you choose to pay online, please record the payment you wish to make, before you submit this form. You will be transferred to a payment page.

If you elected to pay in installments, please check the box below.
 I will mail or charge my payment on or before the payment dates above

MAIL to CPAFC, 432 60th Street, Oakland, CA 94609

CANCELLATION and REFUND POLICY
All requests for refunds must be made in writing to the office. Upon enrollment $registration fee is non-refundable. After June 1, 2011 THERE WILL BE NO REFUNDS GRANTED, regardless of registration date. We suggest that you consider commercial tuition insurance.



THE FINE PRINT - Please read and initial here
I understand that a liability waiver and medical care release must be completed and returned prior to arrival at camp. CPAFC has a zero tolerance policy regarding underage drinking, illegal drugs, theft, weapons and vandalism, and campers found in violation of this policy will be asked to leave. I authorize Cazadero Performing Arts Family Camp to use photographs taken of my family at camp for promotional materials. By providing your e-mail address you may receive updates and information from us and will be included in the Camper Directory at the end of camp, unless otherwise indicated by you, but will never otherwise be sold or shared. I understand that enrollment is on a firstcome, first-served basis and that wait lists will be kept in order of receipt. I have read and understand the refund policy that there are no refunds after June 1, 2012 and that schedules are subject to change.

You are not registered until we receive your deposit.

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