C.E.A. Rental/Reservation Application

Dates planning to camp (ex. 7/03-07/06/2026):*
Is this a holiday weekend?*

YesNo
Camper Length
Total People*
Total Dogs*
Please read and complete the application thoroughly. Please ensure you mark/fill out Amp Site or RV/Cabin/Tent Site location.

Pull in campers will be assigned a location based on the specifications provided.

A 30-day notice is required to qualify for 75% reimbursement (25% holding fee Holiday Weekend reservations are Non-Refundable.

You can view the site map with locations at www.campemeraldacres.com
Name*
Phone*
Email Address*
example@example.com
Address*

Address

Street Address Line 2

CityState

Zip Code
Camper Year
Camper Make
Camper Model
Amp
Do you know any seasonal campers?

YesNo
If yes, who?
We have various sites available with either 30 Amp or 50 Amp electric hook-up

Cost is $45.00 per-night; $90.00 per two-night weekend; $245.00 per-week; $936.00 a month
(does not include taxes).

Holidays are a three-night minimum at $200.00; added $15.00 fee for A.C. per night; added $15.00 fee for 50 Amp limited sites per night
(does not include taxes).
1 Do you prefer to be in a wide open space or a secluded woodsy area?
2 Do you prefer to be around other campers or a quiet, serene atmosphere?
Please choose from the following:

One-Night StayTwo-Night StayHoliday/Three-Night Stay
Our goal is to provide you with your best camping experience based on your specifications

No camper? No problem! We've got rentals ready for your next adventure!
*CABIN SITES

Cabin cost is $95.00 per-night; $190.00 per two-night weekend; $285.00 for a three-night Holiday Weekend (does not include taxes) *Pricing does not include $25.00 cleaning fee
Cabin Sites

A7A8
*CAMPER SITES

Camper cost is $128.00 per-night; $250.00 per two-night weekend; $365.00 for a three-night Holiday Weekend (does not include taxes) *Pricing does not include $25.00 cleaning fee
Camper Sites

RL1RL4LL7IW3Y1
*TENT SITES

Cost is $28.00 per-night; $56.00 per two-night weekend; $80.00 for a three-night Holiday Weekend (does not include taxes) *Can be at any location*
Please choose from the following:

One-Night StayTwo-Night StayHoliday/Three-Night Stay
***STAY LONGER WITH US***

10% Off a 7-Night Stay | 20% Off a 28-Night Stay

Can be used in any month of the 2026 season * Must be consecutive nights * Cannot be used with any other offers, discounts, or promotions * Extra night stays will be an extra charge * All reservations must be booked no sooner than a month is advance * Cancellations must be no later than two (2) weeks in order to qualify for a 75% discount (25% holding fee). Cost below does not include taxes.
Please select from the following:

Amp Site Rental: 7-Night is: $283.50 / 28-Night is $1,008.00Cabin Rental: 7-Night is: $598.50 / 28-Night is: $2,128.00Camper Rental: 7-Night is: $787.50 / 28-Night is $2,800.00
For Amp Sites, what is your Camper Amp?

3050 (has an additional $15.00 per-night fee)
Passport America

Are you a Passport America member? As a member, you get a discounted rate. Please upload your Passport America Membership Card below
***ALL PAYMENTS ARE DUE IN FULL AT THE TIME OF BOOKING***

Please make checks payable to: Camp Emerald Acres - 6629 Abbotts Road - Franklinville, NY 14737
Payments can be made in the following forms:*

CashCheckCard
BY SIGNING, YOU AGREE TO THE FOLLOWING:

*The rates provided per site, camper, or cabin which includes taxes; deposits and fees not included.

*Regular reservations require no less than a 30-day notice to receive 75% reimbursement (25% holding charge).

*There is no reimbursement or transfer of credit for canceling a holiday weekend unless stated otherwise by CEA owner.

*If paying by check, and the check bounces, there will be a Bounced Check Fee of $50.00 attached to your invoice.

*If paying by card, and it bounces for insufficient funds, there will be an Insufficient Funds Fee of $50.00 attached to your invoice.

*The form is filled out to its entirety and all information is true and accurate to the best of your knowledge

**FIREWOOD CAN BE PURCHASED AT THE CAMPGROUND—IT IS STRICTLY PROHIBITED TO BRING YOUR OWN WOOD**

**IT IS STRICTLY PROHIBITED FOR RENTERS TO BRING THEIR OWN GOLF CARTS/ATV’S**
Signature*

Clear
Should be Empty:

*CABIN SITES

*CAMPER SITES

*TENT SITES

Passport America