2021 MBF Farm Camp Registry

2021 MBF Farm Camp Registry
Name of Student

First Name Last Name
Age of Student
Name of Parent

First Name Last Name
Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Week of Choice (Hours 8am-2pm)

Week 1: June 28-July 2 Week 2: July 5-July 9 Week 3: July 26-July 30
Daily/ Weekly Rates
prev next ( X )
Daily Or Cash
$ 10.00 Quantity

Weekly Pay for week in advance, no refunds (donated to scholarship farm program.
$ 75.00 Quantity

Donation for Scholorship Program
$ 1.00 Quantity

Total

$ 0.00
Half day Interest?:

Yes No
Junior Counselor?

Yes No
Allergies?
Should be Empty:

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