Chaperone and Additional Camper Registration form
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Chaperone Name, Group, or Family Name *
Address *
Cell Phone Number *
Chaperone/Additional camper  Full stay (4 days)
It is $160 per person
Person 1: Name
Person 1: List all Dietary  Restrictions
Person 2: Name
Person 2: List All Dietary  Restrictions
Person 3: Name
Person 3: List All Dietary  Restrictions
Grand total for Chaperone/Additional camper full stay (it is $160 per person) *
Chaperone/Additional camper partial stay
Camping fee is $10 per day
Person 1: Name
Days attending
Will you be needing catering?
Clear selection
List All Dietary Restrictions
Person 2: Name
Days Attending
Will you need catering
Clear selection
List All Dietary Restrictions
Person 3: name
Days Attending
Will you need catering
Clear selection
List All Dietary Restrictions
Grand total for Partial stays *
Are you Camping in *
On what days?
Grand Totals
Please add up all expenses in sections above. Add all the fees to the Original $500 or $600 C-camp Registration fee to calculate the total. Please make Check Payable to Midcal Region USPC
Grand total for Chaperone/Additional full stay *
Grand total for partial stays *
Grand total for Form *
Submit
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