Main Contact Name(Required)Email(Required)Phone(Required)RSVP(Required) 1 Attendee 2 Attendees 3 Attendees 4 Attendees Regretfully Decline Please email Megan if there will be more than 4 people in your partyAttendee #1Full NameDietary Restrictions and/or Food AllergiesAttendee #2Full NameDietary Restrictions and/or Food AllergiesAttendee #3Full NameDietary Restrictions and/or Food AllergiesAttendee #4Full NameDietary Restrictions and/or Food AllergiesPayment InformationCamp Manito-wish accepts the following forms of payment. Note credit card payments will be charged a 3% convenience fee upon processing. Please make your selection below.(Required) E-Check Credit Card with 3% fee Paper Check (please mail to: Camp Manito-wish YMCA, PO Box 246, Boulder Junction, WI 54512) Total:(Required) $55 - 1 Attendee $110 - 2 Attendees $165 - 3 Attendees $220 - 4 Attendees 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 (3% convenience fee will be added) Visa Mastercard Discover American Express Credit Card NumberPlease confirm number before continuing.Expiration Date (mm/yyyy)Security (CVV) CodeThe 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 Signature(Required)Date MM slash DD slash YYYY CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
