Camp Bluebonnet Registration Form

Camper First and Last
Name * First Last

School Attending *

Grade entering in Fall 2012 *

Do you have any siblings? *

Number of siblings

Number of sisters

Ages of sisters

Provide the ages of each of your sisters. e.g. - "4 months, 4, 15, 21"

T-Shirt size *

Youth: M Youth: L Adult: S Adult: M Adult: L Adult: XL

Please provide your personal preference for each of the camp classes offered:
	No preference	1st Choice	2nd Choice	3rd Choice
Art	1	2	3	4
Dance	1	2	3	4
Theatre	1	2	3	4

Cabin-mate suggestion

One name only, please.

Father's Name First Last

Mother's Name First Last

Parent's Primary Email Address *

Please provide the primary parent email address which will receive important camp-related communication and the daily Camp News.

Will your mother be attending "Mom's Night with the Stars" on Month 00, 2012?

Yes, she will be there No, not this year

Every year, mothers are invited to stay the last afternoon and night of the camp to watch the campers' talent show. There is no additional cost.

Were you referred to Camp Bluebonnet by someone?

How did you come to know about Camp Bluebonnet?

By whom were you referred to Camp Bluebonnet?

Camp Fee and Required Medical/Waiver Form

The camp costs $550 for the 1st camper in the family and $450 for each additional sister. No checks will be deposited until after April 1st, and only if your daughter is accepted to camp. The required Medical/Waiver Form can be printed from the camp website or downloaded here. This form should be filled and signed by a parent and submitted along with the check payment. Checks should be made payable to Camp Bluebonnet. The mailing address of Camp Bluebonnet is: P.O. Box 19161, Houston, TX 77224. (Please include camper’s name(s) on the check)

Amount of the check that will be sent $ Dollars . Cents

Checks should be made payable to Camp Bluebonnet.

Check Number

Would you like to make a tax-deductible donation to the Camp Bluebonnet Scholarship Fund?

Donation to Camp Bluebonnet

$25 $50 $100 Other

Checks should be made payable to Camp Bluebonnet, which is a non-profit organization, 501 3c.

Other donation amount: $ Dollars . Cents

Some partial scholarships may be available. If asking for a scholarship, please mail a letter of request to the
address noted below.

Camp Policies:
1. All fees and forms are due by March 1st; $50 additional, thereafter. (However, camp can be full before this date).
2. An application is not considered complete until all fees and forms have been received. Once an application is approved, a confirmation will be sent to the camper via e-mail.
3. All applications received before the camp starts will be processed. Checks will be deposited only after camper is accepted. Wait listed campers' fees will be held pending a spot opening.
4. If cancellation by an applicant occurs after May 1st, all tuition is forfeited unless space can be filled.
5. Refunds will be mailed 2-4 weeks after camp starts unless other arrangements are made.

The Board of Directors reserves the right to refuse any application.

Questions? Please contact our registrar via e-mail at: registrar.campbluebonnet@gmail.com

Please mail medical form and check to:

CAMP BLUEBONNET
P.O. Box 19161
Houston, TX 77224-9161

(Please include camper’s name(s) on the check)