Register for Alumni Reunion 2020 - Children and Arthritis, Inc.

Registration Form - Alumni Reunion Camp 2020

Registration for for Alumni reunion

Alumni Reunion Registration Form - 30th Anniversary of Camp Jambalaya Jubilee
Alumni are original parents and diagnosed child camper. Current spouse or children of the original camper are invited to attend. Fees include all meals, lodging in Centenary College dormitories, and recreation for adults and children. Please register by May 15, 2020.
Alumni - original diagnosed child camper*
First Middle Last
Diagnosis*
Will you be able to attend the Alumni Reunion luncheon at 11:30 am on Friday, June 19?
Will you be able to attend Opening Ceremonies at 1:00 pm on Friday, June 19?
Would you be willing to serve on a panel to answer parent questions?
Do you have any comments to share about what camp meant to you or how it has helped you since?
Would you be willing to answer questions in a teen small group?
Alumni email address
Enter Email Confirm Email
Alumni Contact Info
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Will you bring a spouse?
If yes, spouse name:
First Last
Spouse T-SHIRT SIZE
Will you bring any children?
If yes, child 1
First Last
Date of Birth Child 1
Date Format: MM slash DD slash YYYY
How old will Child 1 be on June 19, 2020?
Child 1 T-SHIRT SIZE
If yes, child 2
First Last
Date of Birth Child 2
Date Format: MM slash DD slash YYYY
How old will Child 2 be on June 19, 2020?
Child 2 T-SHIRT SIZE
If yes, child 3
First Last
Date of Birth Child 3
Date Format: MM slash DD slash YYYY
How old will Child 3 be on June 19, 2020?
Child 3 T-SHIRT SIZE
Will you bring parent/guardians who attended camp with you? They may register and pay separately if you wish.
If yes, Parent/Guardian1
First Last
Alumni - Parent/Guardian1 EMAIL ADDRESS
Enter Email Confirm Email
Alumni - Parent/Guardian1 T-SHIRT SIZE
If YES, Parent/Guardian2
First Last
Alumni - Parent/Guardian2 EMAIL ADDRESS
Enter Email Confirm Email
Alumni - Parent/Guardian2 T-SHIRT SIZE
Need for Handicap Accessibility?
- No
- Yes
Handicap accessibility for whom?
Any Allergies?
Number of Dorm Rooms Needed
* Each room has 2 twin beds. Please make a conscious effort to be economical with your selection – we typically assign 1 bed per person, but allow those with babies and young children to choose if they would like less rooms. Centenary College Dorms are set-up where 2 rooms connect to a shared bathroom. If a 3rd room is selected, that room will not be connected to the others. Each family will have its own room(s) and bathroom.
Please specify any special accommodations needed to attend this event.
Do you have any additional questions or comments?
Alumni Reunion Registration Fees: $100/adult and $50/child, which includes your rooms, meals, and all of your activities. Please note there is a $1.50 charge to help cover our online payment fees.
Total children 18 and under attending*
Price: $50.00 Quantity:
Total number of adults over 18 attending*
Price: $100.00 Quantity:
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address (if different from above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cancellations must be received in writing by May 31 at 5 PM for a full refund. If a cancellation is received after that date, the registration fee will be considered a donation to Children And Arthritis, Inc. You will receive tax benefits for this donation to the full extent of the law. Questions/Concerns? Contact our Executive Director, Sheri Rowell Email: ChildrenAndArthritis@Gmail.Com Phone: (318) 200-0667
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Registration Form - Alumni Reunion Camp 2020

Alumni Reunion Registration Form - 30th Anniversary of Camp Jambalaya Jubilee

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