If you plan on attending ADA Camp Carefree
to man a table or station on Opening Day, please complete the registration form below
to be an ADA Camp Carefree GUEST.
Your advance registration assists us in planning for your visit.
For safety reasons, Guests must always be under the
direct supervision of ADA Camp Carefreestaff. Guests are also welcome to join us for meals if your
activity or agreed upon time goes across a meal time. Specific
programs at camp which greatly benefit the campers could not run without
our Guests!
REGISTER AS AN OPENING DAY GUEST
Street Address (line 1)*:
Street Address (line
2):
City*:
State*:
Zipcode*:
Best Phone # to reach me*:
This
is my (please select one):
Home
Phone
Work
Phone
Cell
Phone
Email Address*:
Birthday (month/day
only - no year please)*:
Will you be at least 18 years old by August 1 of this year?
(please select one)
Yes
No
Purpose of your visit (please check all that apply):
American
Diabetes Association Representative
ADA Office:
Flames
Ride
Researcher
Research Program:
Other
(please provide the following):
Other Name:
Is
this your first time at ADA Camp Carefree?
Yes
No,
I last visited camp in (please provide year):
ADA Camp Carefree 2010 Calendar
SUN
MON
TUE
WED
THU
FRI
SAT
8/1
Camp Opens
8/2
8/3
8/4
Bass Fishing Day
8/5
8/6
8/7
8/8
8/9
8/10
8/11
8/12
8/13
8/14
Camp Closes 12 noon
Please check one of the
following as it pertains to your schedule for arriving/leaving camp:
I
plan to visit camp on the following days:
I’m
not sure of exact days/times right now, but I will let you
know by the following date:
I plan to
arrive on this date:
I plan to
arrive at this time:
I plan to leave
on this date:
I plan to leave
at this time:
I plan
to stay for the following meals:
None
Breakfast
Lunch
Dinner
All
Meals
I plan
to stay overnight:
Yes,
and I agree to complete the Voluntary Disclosure Form (provided upon
submission of this registration) if I am not an
ADA Representative.
No
I need
to be contacted to make special arrangements:
