Partner Camp Billing Information

Camp:

Your Name:*

First Last

Your Email*

You will receive a copy of this information.

Bill Recipient Contact:*

Please provide name, e-mail or address information.

Participant Information

# of Campers:*

# of Volunteers (Non-Medical):*

# of Medical Staff:*

# of Extra Meals:*

$5/meal: Includes any day visitors who stay for a meal.

If there are none, please enter 0.

These will be calculated based on pre-camp orders or # of participants.

- Arts & Crafts: $2 per participating camper. If your program did not use CJM crafts, there is no charge.

- Snacks: $2

- Plast Nametags & Holders: $2

- Party Night Shirts: $5

- Leather Name Tags: $2

Please enter the following information regarding which partnering organization campers attend.

If there are none, please enter 0.

Children's Health Campers:*

Children's Health Staff/Volunteers:*

Cook Children's Campers:*

Cook Children's Staff/Volunteers:*

Scottish Rite Hospital Campers:*

Scottish Rite Hospital Staff/Volunteers:*

Other Partnering Organizations:*

If your campers and volunteers come with another partnering organization, please list it below.

Partnering Org:

# of Campers:

# of Staff/Vol

This is the number that will be used to calculate participant cost.

- 4 meals: $75 per person

- 5 meals: $80 per person

- 6 meals: $85 per person