Register For Winter Camp [vc_row no_margin=”true” padding_top=”0px” padding_bottom=”0px” border=”none”][vc_column width=”1/1″]Winter Camp Registration Name Email Address 2nd Human Camper (If applicable) Register For 1 person bringing up to 2 dogs. 2 people bringing up to 4 dogs, in total 2 people bringing only 1 dog, in total Winter Camp Lodging Options * Single Lodge ($475) Double Lodge ($395) Triple Lodge ($345) Off-Site Lodging ($295) Anticipated Event Fee Single Lodge $450 Double Lodge $375 per person Triple Lodge $325 per person Off-Site Lodging $275 per person Two people 1 dog Double Lodge $350 per person Age Gender Male Female Occupation(s) Complete Mailing Address (Street, City, Zip) Primary Phone Number Cell or Work Phone T-Shirt Size (for Canteen Ordering) XS S M L XL XXL XXXL Is E-mail a reliable way to contact you? Yes. Send all camp info electronically. No. Please post-mail all camp info to me. Emergency Contact Name Emergency Contact Relationship Emergency Contact Phone Vets Name Vets Phone How did you hear of Camp Dogwood? I AM DOGWOOD ALUMNI 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...) Details/info for previous question How many dogs will you bring? One Two Three Four Dog #1 Name Dog #1 Age and Breed Dog #1: Where did you get this dog and at what age? Dog #1 Gender and Status male, fixed male, intact (subject to guidelines) female, fixed female, intact (not permitted if in heat) Dog #2 Name Dog #2 Age and Breed Dog #2: Where did you get this dog and at what age? Dog #2 Gender and Status male, fixed male, intact (subject to guidelines) female, fixed female, intact (not permitted if in heat) Dog #3 Name Dog #3 Age and Breed Dog #3: Where did you get this dog and at what age? Dog #3 Gender and Status male, fixed male, intact (subject to guidelines) female, fixed female, intact (not permitted if in heat) Dog #4 Name Dog #4 Age and Breed Dog #4: Where did you get this dog and at what age? Dog #4 Gender and Status male, fixed male, intact (subject to guidelines) female, fixed female, intact (not permitted if in heat) For obedience.. I trained my dog myself I took my dog to obedience classes I worked with a private trainer Obedience? That's not our best subject.. My dogs are Submissive Dominant Goes with the flow.. My dogs (continued) Primarily a backyard dog Encounters other dogs on leashed walks. A frequent park/beach attendee. Successfully co-mingles at doggy daycare.. Participates regularly in organized dog events. My dog has been bitten by another dog My dog has bitten another dog My dog has bitten a person 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 Sometimes my dog "Needs Space" My dog has run away before My dog suffers from separation anxiety My dog is possessive of Me Toys Treats / Food Nothing Is there anything else we should know about your dogs? Payment Information Payment Type Credit Card Check to be mailed ASAP to: Camp Dogwood, 205 Barberry Road, Highland Park, IL 60035 Card Type Master Cart Visa Name as it appears on credit card. Credit Card Number (XXXX-XXXX-XXXX-XXXX) Credit Card Expiration Date Amount to authorize Please determine amount to pay based on number of dogs and classes attending... Does this credit card have the same billing address as provided above? Yes No Billing Address Cardholder Authorization * As the card holder I authorize this transaction Rules and Policies Agreement * I agree to the Camp Dogwood rules and policies Privacy Policy * I have read and agree to the Privacy Policy Captcha [/vc_column][/vc_row]
