Club Participation Form Camp RYLA

Club Participation Form Camp RYLA

District 5770
fill in here Rotary Club will Sponsorfill in here camper(s) at the cost of $500 per camper for a total cost (no. of campers X 500)total
Club RYLA Chairperson/Youth Coordinator Information:
Name

First NameLast Name
E-Mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone ( )
Format: (000) 000-0000.
Home Phone ( )
Format: (000) 000-0000.
Mobile ( )
Format: (000) 000-0000.
I hereby agree to select students who embody the leadership qualities as described in the Camp RYLA Club Handbook. Once selected, I will communicate to them all pertinent camp information (including our Club's commitment to transporting them to and from camp) in a timely manner. I understand that all submitted camper applications are subject to review by the RYLA Camp Director. Furthermore, I agree to meet all Camp RYLA deadlines unless special arrangements are made with the Camp RYLA Director or Camp RYLA District Committee Chairperson.
Signature
Date

MonthDayYear
Date
Check (payable to Rotary Camp RYLA)Online Invoice
Bob Usry
Camp RYLA District Chairperson
Post Office Box 1533
Norman, OK 73070
OR
Savannah Harris Camp
RYLA District Assistant Chairperson
2627 Quanah Parker Trail
Norman, OK 73070
Club Participation Form with club's check due by March 31.
Should be Empty: