Glen Helen Outdoor Education Center

About Glen Helen • Visiting The Glen • School Programs • Support Glen Helen

EcoCamper Registration

(Please submit a separate registration for each camper)
(items in bold are mandatory)

Camper First Name		Camper MI
Camper Last Name
Gender	Grade Finished
School Attended
Camper Birthdate
Guardian First Name		Guardian MI
Guardian Last Name
Address
City
County
State	Zip
Phone (Home)
Phone (work)
Email Address

1st and 2nd Camp Choices
Week 1: June 15 - June 19, 2009

2nd Choice
Week 2: June 22 - June 26, 2009

2nd Choice
Week 3: June 29 - July 3, 2009

2nd Choice
Week 4: July 6 - July 10, 2009

2nd Choice
Week 5: July 13 - July 17, 2009

2nd Choice
Week 6: July 20 - 24, 2009

2nd Choice

Note: If your first choice is not available, we will sign camper up to second choice.
If neither choice is available we will advise you via email and/or telephone.


Fields in bold* are required*
Total for camps selected	$
Donation	$	To provide additional support to the programs at Glen Helen, please consider adding a donation to your total
Total Amount	$	Camps plus donation
Deposit	$	($100 per camp selected)
Prepayment	$	Additional amount of your balance that you wish to pay now. Pay in full now, and save time at registration!
Amount to charge to your credit card	$
Amount due	$	The balance is due when you bring your child for registration on the first day of their EcoCamp. Please bring a checkbook. Credit cards will not be accepted at registration,

Pay By Check
Fill out the registration above, print it and send (along with $100 deposit per camp) to:
Glen Helen Outdoor Education Center
1075 State Route 343
Yellow Springs, Ohio 45387
Make check payable to Glen Helen