Online Family Camp Registration

Primary Contact (Person making registration payment)

First Name*

Last Name*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Phone Type

Email*

Please complete the section below for the entire party including primary contact full names, birth dates, relationship to primary contact and any restrictions.*

Name	Date of Birth	Email Address	Allergies, Medical, Physical or Dietary Restrictions	Relationship to primary contact

Reservation Details

I would like to attend session(s): (Hold down control key to select multiple sessions.)

I/We Wish to rent a:

If you are interested in renting more than 1 cabin or tent, please outline your request below and we will contact you for details

Amount Due

Amount to be paid now (50% of full amount if prior to April 1 or 100% of full amount if after April 1):

Balance is due April 1 Click here for Rate Sheet Your remaining balance is due by April 1 in the form of check or money order. If you are registering after April 1, the entire amount is due at the time of registration. The deposit is non-refundable in case of withdrawal, except in the event of illness. Guests who cancel after April 1 will be responsible for 100% of the total fee if the resulting vacancy is not filled at the time of cancellation. If using a credit card, it will not be charged when you submit this form, but after you receive confirmation from the Ohana Registrar.

Payment Information

We require at least 50% of your payment to be by check.

Credit Card & Check Payment Details

When paying by CREDIT CARD, you will be charged AFTER you receive a confirmation from the Ohana Registrar and NOT when you submit this form. When paying by CHECK, fill out the information below completely, including credit card information. Your credit card will not be charged. Please note in the additional information field that you are sending a check. A check must be received within seven days of registering or your credit card will be charged. Make your check payable to: OHANA CAMP 2968 Lake Morey Road Fairlee, VT 05045

Credit Card*

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Info*

Credit Card Billing Address is the same as Primary Contact Address
Credit Card Billing Address is different than Primary Contact Address

Credit Card Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Information

Important! Please indicate below, as necessary, for each member of your group, any allergies, special medical, physical or dietary circumstances of which we should be aware as your host. If you are designating a dietary preference, please let us know that too.

Phone

This field is for validation purposes and should be left unchanged.

Test name

Position title

Primary Contact (Person making registration payment)

Reservation Details

Amount Due

Payment Information

Credit Card & Check Payment Details