|
Camp
Information Form |
|
Complete this information
and mail to:
The Arc of Dauphin County, 2569 Walnut St.,
Harrisburg, PA 17103-1760 |
| Name:
__________________________________________________________________________ |
| Address:
________________________________________________________________________ |
| City:
_____________________________________ State:
_________ Zip: _______________ |
| Phone (Day):
(______)__________________
(Evening): (______)___________________ |
| E-mail:
_________________________________________________________________________ |
| Camp Name:
____________________________________________________________________ |
| Camp Date(s):
___________________________________________________________________ |