A.R.C. Natural History Day Camp
Jr. Session June 21 - 25

Regular Session June 21 - July 2
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Name of Camper ______________________________________________ Today's Date ________________


Address ____________________________________ City __________________ State _____ Zip _________


Birth ________________ Age (camp time) _____ Entering Grade ____ At ______________________ School


Parent or Guardian _________________________________________________________________________


Phone (home) ________________________ Work/Cell ____________________________________________


E-mail ____________________________________________________________________________________
Please include a $20.00 registration fee. Make checks payable to ARC Natural History Day Camp
Return this form to:

ARC Natural History Day Camp
8594 Faber Rd
Faber VA 22938