Vision Quest Camp Registration Form

Vision Quest Camp Registration Form

June 17th 11 am – June 22nd Mid-afternoon

Deer Haven – Terrebonne, OR

Only one form required per family. Registration due June 12th

Send Registration Form along with checkto r mail to:

6533 SE 69th Ave. Portland, OR 97206

For information about this ceremony, what to bring, what not to bring, etc, please visit our website:

Adults/Elder’s Name(s):

Young Adults / Children’s Name(s):

Ages:

Address:

Phone number:

Email:

Are you already on the Four Winds Foundation email list?

Yes No

Will you be attending the entire camp, June 18th – 23rd?

Yes No

If dropping in, which days would you like to come?

6/17 6/18 6/19 6/20 6/21* 6/22*

*Note that the last two days of camp are not open for one-day drop-ins, as these are the days the pledges come down from the mountain and have their give-away. We encourage people to come support during the time when the pledges are on the mountain. Please inquire for more information.

Do you have any preexisting health conditions, disabilities, or special needs we should be aware of?

No Yes (if so please explain):

Emergency Contact:

Are you on a special diet? Please circle all that apply:

Vegetarian Vegan Gluten-free Other (please explain):

Do you have any food allergies or sensitivities?

No Yes (if so please explain):

Payment

Payment covers three meals a day, water, ceremonial materials, firewood, land usage, kitchen/composting toilet/changing room facilities, and Elder expenses.

Please send a deposit of $100 ($20 per day if dropping-in) along with your registration.All registrations and deposits are due by June 11th

Full payment due the first day of camp, June 18th

Early Bird recipients must pay in full by May 15TH at midnight

*Children are ages 12 and under

*Young Adults are ages 13 – 20

*Adults are ages 21 - 64

*Elders are ages 65 +

Make checks payable to Four Winds Foundation

Amount due (please write out all information as exemplified below):

Example:

2 Full Camp Adults & 1 Young Adult both with Early Bird Discount

($242 X 2) + $218 = $702

Directions to Deer Haven can be found at:

We look forward to seeing you there!

Four Winds Foundation

503-680-9831