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.
Paid in Full by May 15th (Early Bird Discount!) / Paid in Full by June 12thFull Camp Adults* / $242 / $285
Drop-In Adults* / $55/day / $65/day
Full Camp Young Adults* & Elders* / $218 / $257
Drop-In Young Adults & Elders / $49/day / $58/day
Children* / Free / Free
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