[ ] Jr. Session June 9 - 13

[ ] Regular. Session June 9 - 20

A.R.C. Natural History Day Camp

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

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