Junior 4-H Camp Application
Camp Fortson – Hampton, Georgia
June 1st – 5th, 2009
Total Cost of Camp is $300.00
(Camp fee includes, insurance, meals, lodging, transportation, T-shirt, and all camp activities)
Amount Enclosed:
___ Cash ___$75.00 Deposit (Camp balance - $225.00 due on or before May 8th)
___ Check ___ $300.00 Total Camp Cost
Parents Please Fill Out Form To Ensure Information is Correct!
Name: ____________________________________________________________________
Address: _________________________________________________________________
Parent/Guardian Name: _____________________________________________________
Home Phone #________________________ Work Phone #________________________
Cell #___________________________ Emergency Phone #________________________
E-mail address ____________________________________________________________
Age of 4-H’er ____ Grade ____ Male ____ Female ____
T-shirt Size: Youth Small Youth Medium Youth Large Youth XL
Adult Small Adult Medium Adult Large Adult XL
I do hereby consent to allow my child to attend 4-H summer camp at Camp Fortson
4-H Center, in Hampton, Georgia and understand that he/she will be under the supervision of the 4-H Camp Staff and Counselors while attending camp. I will discuss the importance of good behavior and following the rules while at 4-H Camp.
_____________________________ _______________________
Parent/Guardian Signature Date