Apache Belle Pow Wow Summer Dance Camp Registration Form

Apache Belle Pow Wow Summer Dance Camp Registration Form
Thank you for registering for the Apache Belle Pow Wow Summer Dance Camp. If you have any questions, please email apachebellepowwow@hotmail.com.

Camp: June 27-30, 2012
For Ages: 13-18
Housing: Ornelas Complex on the Apache Belle Floor
Meals: Rogers Student Center Cafeteria

Early Bird Registration: February 1st, $200
Regular Registration: April 1st, $225
Late Registration: June 1st, $250
Participant

First NameLast Name
Birth Date

MonthDayYear
High School
Graduation Year
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Parent/Guardian

First NameLast Name
Parent/Guardian Phone

Area CodePhone Number
Unisex T-Shirt Size
Roomate Preference
Contact Information
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