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image map spacer Summer Camp Registration

To sign up for Summer Camp at White Pines Ranch, just complete this form, print it out, and mail it to us along with your $50 deposit per week. We will send you a confirmation letter via postal mail along with registration forms and a list of what to bring.

Camper's Name:
Address:
City:
State:
Zip Code:
Age:
Birthday:
Parent's Name:
Home Phone #:
Work Phone #:
Dates for camp:
Sunday, to Saturday,
Names of friends coming to camp (remember, you have to be very close to the same age to be in the same activity group):
Friend 1:
Friend 2:
Friend 3:
 




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White Pines Ranch
3581 Pines Road, Oregon, IL 61061
phone: 815-732-7923
fax: 815-732-7924