Registration Form

  Camp Sturtevant Hike and Dance Weekend

Name _________________________________ Address _______________________________________

City/State/Zip __________________________________________ Female ___ Male ___

Phone: w___________ h_____________ e-mail ___________________________________________

(Please indicate what information you do not want released on a registrant list)

Meal Req.: Vegetarian ____ Non-dairy _____ Omnivore _____ Other (Describe) _________________

Carpools: Willing to take ______ passengers; Looking for a ride ____

Send a check for $145 plus a $6 deposit/person for burro packing (if desired) to:

Dixie Swanson

517 Hoover Court

San Dimas, CA 91773

Please make checks payable to: "Richard Cageao" and include a Self-Addressed, Stamped Envelope

Application deadline: Sept. 23; Cancellations after Sept. 23 forfeit registration fee.