Family Winter Retreat

Adult 1:

age:

adult 2:

age:

adult 3:

age:

adult 4:

age:

child 1:

age:

child 2:

age:

child 3:

age:

child 4:

age:

child 5:

age:

child 6:

age:

adress:

phone number:

email:

housing request:

Camp Friedenswald cannot guarantee that each request can be accomodated but will do its best to ensure the comfort of all our guests

special needs:

please let us know of any dietary or physical needs that camp should be aware of during your stay. Also feel free to note here any other persons and their ages if your family exceeds the number of spaces allotted above for names and ages.

I hereby certify that the above information is accurate and I give my permission for the used of photographs and video of my family to be use in camp publicity. (Type name in place of signature).: