2007 Mammoth Cave Restoration Field Camp Application for the weeklong
Aug. 6-10
Mail to:  Roy Vanhoozer
              PO Box 1277
              Lexington, KY 40588.
along with check made payable to Roy Vanhoozer.
 
Name____________________________________________________
 
Address_________________________________________________
 
City__________________ State___________ Zip_____________
 
Home Phone(_____)______________
 
Age ______________________ (if you are under 18, a parent or guardian
                                                must also complete a parental consent form and                                            an adult  must accompany you at camp)
 
Grotto___________________________________
 
E-mail___________________________________
 
List any special food requirements (allergies, vegetarian, etc.):
_______________________________________________________

 
Please list any medical experience/knowledge you have that could help
in an
emergency/accident:
 
________________________________________________________
What are your plans for sleeping arrangements?  Marking bunkhouse does
not guarantee a space.  The bunks will be assigned in the order
received.  You will  be contacted if we run out of bunks.
bunkhouse/house  _______________________
camping               _______________________
hotel/off site/other  ______________________
 
Number of T-shirts        __________@ $9.00 ea __________
 
Size(s)               ____ ____ ____
 
Camp Fee                              $60.00 each        __________
 
Total remitted                            ____________

EMERGENCY CONTACT/MEDICAL INFORMATION
The emergency contact information must be completed. All information is
confidential.
 
In case of emergency contact: __________________________________
 
Relationship:_____________________
 
Phone: (H)__________________________(W)_________________________
 
Address:  _______________________________________________________
 
                _______________________________________________________
 
This information is optional at your discretion, but could be
beneficial in case of a medical emergency.
Do you have any of the following:
Allergies         
                                        
__________________________
Chronic/Recurring illness         
                 
_________________________
 
Surgery or serious illness in the past year   _________________________
Medications         
                                    
_________________________
Heart or breathing problems     
                 
_________________________
Other                           
                            
__________________________
 
Anything else you'd want EMT/medical personnel treating you to know:
 
_________________________________________________________________
 
_________________________________________________________________
 
_________________________________________________________________