Metal Cowboy Banner
Bestselling Author - Performer - Journalist - Educator - Adventure Dad
Camp Registration

Please drop by and sign the Guest Book when you get a chance! Yehaw!!!



At the Bike Rack
The Cowboy outside his bike rack at Powell's - Portland

Seach the
Metal Cowboy site


Rolling Roads Bicycle & Active Sport Vacations!

2008 Camp Creative Summer Registration
 
Camp Creative Logo

Registration for 2007 Camp is closed, we are now accepting
camp registrations 2008

Fill out this form to register for a 2008 summer camp session. You may use the SUBMIT button to send this registration via e-mail or print it out and mail it to:

Camp Creative
2820 N. Willamette Blvd.
Portland, Oregon 97217
(503) 239-6985

A nonrefundable deposit of $100 per session is required. Upon completion of this registration form you will be given the opportunity to make a deposit via credit card or PayPal, if mailing your registration you may also include the deposit check at that time. Registration forms received that are not followed by a deposit and credit card information to secure full payment are not guaranteed a spot in the camp session chosen. If you prefer, you may call in your credit card information after submitting this registration form.

Phone number (503) 239-6985.

Registering Parent/Guardian Information
*Registering Parent/Guardian Name:
*eMail address:
*Re-enter Parent E-Mail Address:
Camper Information
*Camper's Full Name:
Male  Female
*Age at Camp:
(Kids Camp ages 9-17)
(Family Camp age 3- 99)
Grade Entering in 9/07 *Birthday (mm/dd/yy):
*Parent/Guardian Name 2:
*Address:
*City: * State:   *Zipcode:
*Home Phone:
*Mobile or Pager:
*Emergency Contact Name:
*Emergency Phone:

Parent Occupation Company Name Daytime Phone#
Mother:
Father:

Friend of Camp Creative Member?          

How did you hear about Camp Creative?

Recruited by:   

One Cabin Mate Request:

Comments and/or Requests:
 

Please check session(s) desired

2007 Summer Camp Schedule

Session Dates
Session
Cost

Session 1 - Kids 9-17
Sauvie Island
June TBD $495

Session 2 - Kids 9-17
Columbia Gorge Loop
June TBD $495

Session 3 - Kids 3-8
Family Camp - Columbia Gorge Loop
June TBD $250
Session 3 - Kids 9-17
Family Camp - Columbia Gorge Loop
June TBD $395
Session 3 - Adults
Family Camp - Columbia Gorge Loop
June TBD $495
* During Family Camp - Admission for  children under 3 years of age is free

Session 4 - Kids 3-8
Family Camp - Olympic NP, Washington
June TBD $250
Session 4 - Kids 9-17
Family Camp - Olympic NP, Washington
June TBD $395
Session 4 - Adults
Family Camp - Olympic NP, Washington
June TBD $495
Please check back regularly, additional sessions in July may be added.

Discounts:
Will be applied when verified
  • $25 - for recruiting a new camper (non-sibling) who lists you as the Recruiter on their application
  • $25 per sibling registered
  • $10 Friend level - Friends of Camp Creative Member
  • $20 Patron level - Friends of Camp Creative Member
  • $30 Sponsor level - Friends of Camp Creative Member
  • $50 Benefactor level - Friends of Camp Creative Member
  • $25 for multiple sessions (discount applied to 2nd session)
  • $20 for 1 week session if registered before December 31, 2006.

Release Information

Release

PLEASE NOTE:

A MINIMUM $100 DEPOSIT IS REQUIRED TO RESERVE EACH PERIOD AND MUST ACCOMPANY THIS APPLICATION. There will be no refunds when a child goes home early in case of disciplinary action. We or I (parents) approve this application and certify that our child is in good health. Acceptance of this application is contingent upon the camper passing a physical exam by the family physician within one year before leaving for camp.

Camp Creative Carries an ACA brokered Insurance policy but does not furnish accident/illness medical insurance. Medical bills, including prescription drugs, will be the responsibility of the parents. In the event I cannot be reached in an EMERGENCY, I do hereby give my permission to transfer child named above for the purpose of medical care or program activities as deemed appropriate by the Director. I hereby give my permission to the physician selected by the Camp Director, to hospitalize, secure proper treatment for my child as named above.

I(We) have read and Agree to all terms and conditions of this registration*

Payment Information

Payment

Upon clicking the submit button below you will be taken to a confirmation page, at that time you will be given the opportunity to make a deposit by credit card or PayPal. You may pay for this camp session in full or pay a minimum deposit of $100.00 per session.

Please send me a scholarship application package.


Verification & Anti-spam

We use special verification to prevent spam,
please enter the verification characters you see in the image before submitting this registration: Please note, we do NOT use auto-responder email to confirm your submission, you will receive a manual confirmation within 72 hours.
Image verification

 
 

Stop Spam! OnGuard OnlineWE REPORT SPAM
OnGuardOnline.gov provides practical tips from the federal government and the technology industry to help you be on guard against Internet fraud, secure your computer, and protect your personal information. Click on the image or visit the US Federal Government FTC website for more information!

Notice to Spammers: We report ALL spam to the
US Federal Government in support of the CAN-SPAM Law.
footer
Camp Creative Logo

Contact Joe | Fan Club | Cowboy Blog | Newsletter | Press Kit | Guestbook | Employment | Site Map | Privacy
Copyright © 2006 Joe Kurmaskie- Metal Cowboy - All rights reserved.
Website development by Hancq Computing - Website design by Joe Kurmaskie & Gary Hancq
Contact the Webmaster

This website works best when viewed with Internet Explorer 6+ Netscape 7+ or Mozilla at 1024x768 resolution or greater.

Rolling Roads Logo