Women's Camp Registration

Name:__________________________________________________

Address:___________________ City ________________ State:_____ Zip:________

Phone:____________ Email**:____________________________ DOB (mm/dd)__________

**If providing an email address your camp confirmation package will be emailed to you. Otherwise it will be sent via post (snail mail). Please help us go green by providing a valid email address!!

Mail to: Women's Camp C/O Judy Porter, PO Box 22, Unity, Maine 04988
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I would like to register for (Select all that apply):

[ ] SPRING FLING WEEKEND 2010 (Lodging free of charge) May 8 - 10, 2010

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[ ] SUMMER 2010 - $40 / night.* Minimum of 3 nights please.
August 18 - 24, Camp Scelkit

Circle the nights you will be at camp:

Aug 18 Aug 19 Aug 20 Aug 21 Aug 22 Aug 23
Wed Thurs Fri Sat Sun Mon
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[ ] FALL 2010 session $60 / weekend*
Oct 8 - 10. Location TBD

For the potluck I will be bringing (Please check one):
[ ]-a main dish [ ]-a salad [ ]-a dessert [ ]-other ___________________________________
Please don't leave this part blank as it helps us with the menu planning.

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[ ] WINTER 2011 session $55 / weekend*
Jan 21 - 23  Location TBD

For the potluck I will be bringing (Please check one):
[ ]-a main dish [ ]-a salad [ ]-a dessert [ ]-other ___________________________________
Please don't leave this part blank as it helps us with the menu planning.

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[ ] *I am not a registered Girl Scout and have added $12 to cover my registration
[ ] I am currently registered with the ___________________________ Council

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