2010 Online Registration Form

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Dogwood on Video

2010 Online Registration Form

Thank you registering for Camp Dogwood. Online Registration system is new and all registrations will still be confirmed individually. We ask that you choose a first and second housing choice when registering for Spring or Fall camps. As much as we try to accommodate all applications, your first choice may not be always be available. If unavailable, we will confirm your second selection. Couples should note: Listed Rates are all shown per individual human camper, and up to two dogs per registration. Couples may register together using ONE FORM, but make sure to select indicate "couple" on the form and make sure to calculate any fee(s) x2 in the "Anticipated Fee / Authorized Charge" section.

Registrations for Winter 2010 are processed with full payments of camp fees. Please review our payment and cancellation policies (found at bottom of Registration page) before submitting your registration. And make sure to indicate you've read, and agree to, these policies by checking the box on the registration form.

Thanks again for your interest and for registering. A camp representative will be in contact if there are any questions about your registration or the availability of your choices. We look forward to seeing you at camp very soon!

* Required fields
Name *
E-mail Address *
This registration is for	one individual a couple (two people) my DOG 2 info (your name + dog's info only) my DOG 3 info (your name + dog's info only, +$50)
Age
Gender	male female couple
Occupation
Mailing Address
Home Phone
Work Phone
Cell Phone
T-Shirt Size
Is E-MAIL a reliable contact for you?	Yes. Send all camp info electronically. No. Please post-mail all camp info to me.
Emergency Contact
Emergency Phone
Vet's Name or Office & Telephone
How did you first hear of Camp Dogwood?	Referral. (Enter referrer in next field...) Internet. (Enter site in next field...) Advertisement. (Enter publication...) Editorial. (Enter publication...) Web link. (Enter website...) Other. (Please detail...)
Please enter detail from previous question
	Check here if you require VEGETARIAN meals at camp
Choose a Camp Dogwood Session
EXTENDED CAMP?
WINTER Housing Options
SPRING/FALL Housing 1st choice:
1st Choice Housing TYPE	Rustic Cabin Rustic Cabin (PLUS) Rustic Lodge The New Lodge None: I've chosen OFF-SITE None: I've chosen a DAYPASS
SPRING/FALL Housing 2nd choice:
2nd Housing Choice TYPE	Rustic Cabin Rustic Cabin (PLUS) Rustic Lodge The New Lodge None: I've chosen OFF-SITE None: I've chosen a DAYPASS
My roomate(s) at camp should be: (list names)
	Check if you need us to try and match you a roommate(s) for Double or Shared accommodations.
Add Workshop or Clinic? (SPRING/FALL)
Do you ever work or volunteer with dogs?	Yes. (Please detail below.) No.
If yes above: How -or- With Who?
How many dogs are you bringing to camp?
Dog 1: Name/Age/Breed
Dog 1: Gender & Status	male, fixed male, intact female, fixed female, intact
Dog 2: Name/Age/Breed
Dog 2: Gender & Status	male, fixed male, intact female, fixed female, intact
Where did you get your dog(s), and at what age(s)?
Are there any factors to take into account for you or your dog as we pair roomates? (if applicable)
For Obedience...
Enter any personal info we should know about this dog in the space provided. Then complete the section below about this dog.
My dog is...
	Primarily a backyard dog
	Encounters other dogs on leashed walks
	A park/beach dog
	Successfully co-mingles at doggy daycare
	Participates regularly in organized dog events/activities
	My dog has been bitten by another dog
	My dog has bitten another dog
	My dog has bitten a person
	My dog marks territory outdoors
	My dog marks territory indoors
	My dog is FRIENDLY
	My dog is PLAYFUL
	My dog is ENERGETIC
	My dog is WELL-MANNERED
	My dog is TERRITORIAL
	My dog is FEARFUL
	My dog is NERVOUS
	My dog is LAID BACK
	My dog sometimes needs "space"
	My dog has run away before
	My dog suffers from seperation anxiety
My dog is possessive of:
Are there any topics, activities or suggestions for speakers that you have interest in?
Are YOU able to add anything fun to our schedule? This can be (but not limited to) dog activities. (*Example: yoga instructor, great storyteller, Oprah's buddy ...etc.)
This payment is my	$200 deposit for an individual $400 deposit for a couple Payment-in-Full ("Anticipated Total" below)
Enter Discount Code or Coupon ID here:
Anticipated Discount:
Payment Method	My Check will be mailed within 24 hours. My Credit Card info provided below.
Name on card
Credit Card Type
Credit Card Number
Expiration Date
Anticipated Total / Authorized Charge
Does this card have same billing address as provided as registration address?
Credit Card Billing Address (if different than Mailing Address above)
	As cardholder, I authorize this Camp Dogwood purchase
	I agree to all Camp Dogwood rules, policies ( http://www.campdogwood.com ), and all payment terms.

I have read and agree to the Privacy Policy *

Spam prevention

Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

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Before hitting Submit...

• Have you completed the above form completely?
• Have you submitted your payment information? (*or post-mailed your check)
• Have you fully reviewed our NEW 2010 Payment & Cancellation Policies?
• Have you considered any of our 2010 Extended Camp Options?

If you have additional forms to complete for a DOG 2 or a DOG 3, please do so immediately after submitting this form.

Thanks again for joining us during our 10th Anniversary Season of camps at Camp Dogwood 2010.

A camp representative will confirm your submission and email a pre-camp packet within a week.
Thanks and see you in 2010!