6-Day Family Camp Registration- 2024 Main Contact Name(Required) Maiden Name (if alum) Address(Required) Street Address Address Line 2 City State ZIP Phone(Required)Phone 2 (optional)Birth Date(Required) MM slash DD slash YYYY Email(Required) T-Shirt Size*(Required) Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024How did you learn about Camp Manito-wish?Please Select OneAdvertisementCamp FairFriend/FamilyInternet/WebsiteManito-wish Info. EveningSchoolOtherCamp Manito-wish will be collecting dietary needs and intolerant/allergic to information prior to your arrival Information On Other Family/Group Members Who Will Be Attending:Attendee #1Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #2Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #3Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #4Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #5Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #6Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #7Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024Attendee #8Full Name Relationship to YouPlease Select OneChildSpouseParentGrandchildGrandparentNiece/NephewAunt/UncleCousinOtherManito-wish Alumni? Yes No Birth Date MM slash DD slash YYYY Address (if different from yours above) T-Shirt Size* Youth L Adult S Adult M Adult L Adult XL *For registrations received by January 31, 2024If you plan for more than eight attendees? Please email camp@manito-wish.org so that we can assist.Cabin Preference: Please list three cabin preferences.Cabin Choice One(Required)Select OneBay RidgeBirch LodgeBirdhouseBunkhouseDundeeEagle RidgeFairviewHilltopIdlewildIsland ViewLakewoodLast Resort ILast Resort IINorthNorwayPine GrovePortageurPowerhouseShorewoodTall PinesTimber LodgeVoyageurWaldhusWhite PineWildwoodCabin Choice Two(Required)Select OneBirch LodgeBay RidgeBirdhouseBunkhouseDundeeEagle RidgeFairviewHilltopIdlewildIsland ViewLakewoodLast Resort ILast Resort IINorthNorwayPine GrovePortageurPowerhouseShorewoodTall PinesTimber LodgeVoyageurWaldhusWhite PineWildwoodCabin Choice Three(Required)Select OneBay RidgeBirch LodgeBirdhouseBunkhouseDundeeEagle RidgeFairviewHilltopIdlewildIsland ViewLakewoodLast Resort ILast Resort IINorthNorwayPine GrovePortageurPowerhouseShorewoodTall PinesTimber LodgeVoyageurWaldhusWhite PineWildwoodCabin SharingYes, I would like to share or be placed in a cabin with another family. Please indicate family/group here: If you choose not to share a cabin, you will pay the greater of the cabin minimum or the per participant fees.How many adults will be attending?(Required)0123456(@ $1,050.00 each)How many children will be attending? (3-12 yrs)(Required)0123456(@ $700.00 each)How many children (under age 3) will be attending?(Required)0123456(Free)The program fee is the greater of the cabin minimum of $4,900 or the calculated fees per participant. Financial assistance is available, please complete and return the Campership Request form. A minimum deposit of 50% of the (greater of the cabin minimum or) calculated fees per participant is required with application. Balance due by April 30, 2023 or if registering after April 30 full amount is due at the time of registration.Payment OptionsCamp Manito-wish accepts the following forms of payment. Note credits payments will be charged a 2% convenience fee upon processing. Please make your selection below.(Required) E-Check Credit Card with 2% fee Paper Check (please mail to: Camp Manito-wish YMCA, PO Box 246, Boulder Junction, WI 54512) Amount to Charge(Required) For Total Fee For 50% of Total Fee (Balance due by April 30, 2023) Bank Name (for eCheck) Account Type (for eCheck) Checking Savings Bank Routing Number (for eCheck) Please confirm routing number before continuingBank Account Number (for eCheck) Please confirm account number before continuingCredit Card Type (2% convenience fee will be added) Visa Mastercard Discover American Express Credit Card Number Please confirm number before continuing.Expiration Date (mm/yyyy) Security (CVV) Code The security code on the back of your card.Billing Information Check if Credit Card Billing Information is Different from the Main Contact Information and complete the fields below. Card Billing Address Street Address Address Line 2 City State ZIP Cancellation / Policy Agreement I hereby apply to attend Camp Manito-wish YMCA. Enclosed you will find either the total camp fee or the minimum required deposit of 50% of total fees which I understand will be credited toward the camp fee if I am accepted for enrollment. I agree to pay the total camp fee on or before April 30, 2023 or upon registration if after April 30. I understand that in the event of my family's cancellation: Before Feb 1, Manito-wish will retain $100 Between Feb 1 and June 1, Manito-wish will retain the full deposit After June 1, Manito-wish will retain the full fee Photo/image-use information: I hereby give permission to use any video, photographs, or written statements from my child's experience in public relations materials including the internet without compensation.Consent(Required) I have read the above Cancellation and Photo Information and agree to all the terms*(Required) Waiver Information I understand that although Camp Manito-wish YMCA has taken reasonable steps to provide my family with appropriate training, equipment and skilled staff for his/her camp experience, I acknowledge that some inherent risks cannot be eliminated without destroying the unique character of these activities. Such risks include, but are not limited to, those associated with canoeing, portaging, backpacking, sea kayaking, waterfront activities, horseback riding, wildlife, vehicle transportation, and other components of the camp experience and wilderness travel. Aware of the risks and willing to assume them, I hereby waive, release and agree to hold harmless the Camp Manito-wish YMCA Inc., their representatives and successors for all claims or liabilities of any kind arising out of my family's participation in this camp experience. I have read the descriptions of the session, understand the requirements for participation, and give my family permission to participate. I assume and accept full responsibility for my family's participation. IN CASE OF SURGICAL EMERGENCY, I hereby give my permission to the physician selected by the Camp administration to hospitalize, secure proper treatment for, and order injection, anesthesia or surgery for members of my family. I accept responsibility for medical/surgical treatment charges which may be incurred on my family's behalf. Consent(Required) I have read the above Waiver Information and agree to all the terms*(Required)Applications are processed in the order they are received. The session you are applying for may be full. You will be contacted if you are placed on a waitlist for the program of your choice. Confirmation letters of the receipt of your application will be mailed soon.Signature(Required) Date MM slash DD slash YYYY CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
