PSEA Camp Reservations
AVAILABILITY ON OUR WEBSITE @ WWW.PSEA.INFO
DEPOSIT MUST ACCOMPANY THIS FORM
· A $100 deposit is required to hold full week camp reservations. For partial reservations the deposit is $20 per night.
· A $200 deposit will be required for the Motel or Cookhouse at Wishon Cove.
· CANCELLATION POLICY: NO REFUND within 30 days of the first day of reservation. Fifty percent of the deposit will be withheld for 31 – 60 day cancellation.
· Mail this form with deposit to 1390 Willow Pass Rd. Suite 240, Concord, CA 94520 or fax to 925-246-6230.
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Member Name Social Security # xxx – xx - _ _ _ _
Daytime Phone # E/mail address_________________________
(Please Print Clearly)
CAMP REQUESTED # CABINS ARRIVAL DATE DEPARTURE DATE CABIN REQUESTED
___________________ ________ _______________ __________________ ___________________
*If your camp/date/cabin is already booked, would you like us to contact you for alternate camp/date/cabin? Y N
Wishon Cove applicants, please check desired accommodations:
q Cabin q Camp Site q Trailer/RV Site q Dorm Room q Boat Dock q Guest Motel q Cookhouse
Comments:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
My family and I agree to comply with the rules governing the conditions of camp occupancy.
Signature of Member: _______________________________________________________ Date: _______________
Deposit of $___________included. YOUR PAYMENT MUST ACCOMPANY THIS FORM.
Payment Method: __Check Enclosed 3 digit security code
__Visa/Mastercard__________________________________(______)____Exp.Date_________
__PSCU Transfer
Full payment is due 60 days prior to the reservation date. For assignments with starting dates less than 60 days from the reservation date, full payment is due immediately.
By signing I agree that the use of the PSEA camps is at my own risk, and in consideration for being allowed to use the camps, it is agreed that the Pacific Service Employees Association and PG&E, together with the assignees, officers, agents, employees and officials of any or all of them and their successors are hereby released and discharged from any and all liability (including that resulting from negligence) for personal injuries (including death) that may be received by me and from all claims and demands with regard to damage to my personal property growing out of or resulting from the events contemplated, except to the extent the same is caused by the willful misconduct or active negligence of the foregoing.