Group Name:  * Responsible Party / Contact Name:  * Contact Phone Number:  * Type of Group: Men Women Adults Youth Children Family Young Boys Young Girls	Address:  * City:  * State:  * Zip Code:  * Email:  *	Arrival Date and Time:  * Departure Date and Time:  * Choose meals you would like (refer tot Menu under Forms): Number of Overnights:  * Number of Estimated Campers:  *
The PanFork Policies and Procedures (under Forms) will be read and followed entirely: I Agree Damages to PanFork property by your group will be your responsibility: I Agree You will provide an adult sponsor to take care of the medical concerns of your campers: I Agree As the Responsible Party I (the undersigned) acknowledge that the information herein is correct: I Agree "Responsible Party (electronic signature):" Date Submitted: Comments or Special Requests: Do not enter anything in this field:

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