Author: Kathi

Elkus Ranch Environmental Education Center

2015 Summer Camp Registration

Use this form to register and pay with a check. To register online and pay with a credit card go to : http://ucanr.edu/survey/survey.cfm?surveynumber=14953

————————————————————————————————————————--Registration Form (If more than one child will be attending camp, please use a separate
registration form for each child. ) PLEASE PRINT.
Child’s Name: __________________________________________ Age: ______ Gender: M F
Parent/Guardian: ________________________________________________________________
Address: _______________________________________________________________________
City: ________________________________Zip: __________ Email: _______________________
Phone (H) ___________________(W) ___________________(Cell): _______________________

Please indicate day(s) your child would like to attend:
Session I : June 15 16 17 18 19 Session II : June 29 30 July 1 2 3
Session III: July 13 14 15 16 17 Session IV: July 27 28 29 30 31
Session V: August 10 11 12 13 14
Total # of days: ________ @ $65/day = Total Camp Cost $ _____________

Make checks payable to : UC Regents
Mail registration form and check to : Elkus Ranch Summer Camp
80 Stone Pine Road, Suite 100
Half Moon Bay, CA 94019

NOTE: Cancellations made on or after the first scheduled day of attendance may be eligible for a refund if we are able to fill the vacancy. Please note there will be a $15 processing fee charged when cancelling. Call (650) 712-3151 for further information.

Confirmation will be sent by email.