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4-H Camp Whitewood
2007 Summer Camp Registration
Print out this form, complete the application and return with a deposit to the camp office:
Overnight Camp Sessions
for youth 8-14 years old
(age 8 by January 1st and in third grade)

For Office Use Only  Optional Payment Plan
(Camp fee to be paid in full prior to check-in date)
_____Cash  April 1/3 of Total $67.00 _________
_____Check/Money Order May 1/3 of Total $67.00 _________
_____ Date Received June 1/3 of Total $66.00 _________

 
Please fill out all the information below and mail it back to the address at the bottom of this page
Name:                                                                                  
Age:
   Male     Female                            
Mailing Address:                                                                             Date of Birth:
City:                                                                      
State: Zip:                   
Home Phone:___________________________

Parent Work Ph:_________________________

Parent Cell Ph:__________________________ 		County of                        
Residence
Parent or Guardian Signature:

Sessions
Each week is sponsored by a different county extension office.  You may select
any camp week regardless of your county of residence.
Circle Desired Dates
Length of Days 
Session 1 -  $175.00 Camp Fee (Columbiana County)
 Jun 10-Jun 15
6 days
Session 2 -  $200.00 Camp Fee (Lake County)
 Jun 17-Jun 23
 7 days
Session 3 -  $200.00 Camp Fee (Ashtabula County)
Session 3 only-Campers who wish to be assigned same cabin must submit registrations in the same envelope 		Jun 24-Jun 30
7 days
Session 4 -  $200.00 Camp Fee (Portage County)
 July 8-July 14
7 days
Session 5 -  $185.00 Camp Fee (Geauga County)
 July 15-July 20
6 days
Session 6 -  $200.00 Camp Fee (Mahoning County)
 July 22-July 28
7 days
Session 7 -  $200.00 Camp Fee (Trumbull County)
 July 29-Aug 4 7 days
Special Session - Women's Retreat Weekend
Visit the web site: www.geocities.com/whitewoodladies/
 July 6-July 8
 3 days

For funding purposes, indicate race (optional)  Caucasian ______  Hispanic ______  African American ______

Caucasian/African American ______  Caucasian/Asian ______  American Indian (AI)/Alaska Native (AN) ______

White and AI/AN ______  African American and AI/AN ______  Native Hawaiian/Pacific Island Mixed ______

Type of Residence:  Farm ______  Rural ______  Town ______  Suburb ______  City ______

Is there anything you wish to share about this camper that would help camp staff provide them with a positive and
safe camping experience?

_______________________________________________________________________________________________________


Return form and Payment to:
Summer Camp Registration
4-H Camp Whitewood
7983 S. Wiswell Road
Windsor, Ohio  44099
Telephone Registrations and More information Call:
Locally: (440) 272-5275
Long Distance: 1-800-967-CAMP (2267)
Fax: (440) 272-5276
web site: http://www.ag.ohio-state.edu/~wwood4h/

e-mail: ablair@cfaes.osu.edu

How Did you learn about Camp Whitewood?
__Newspaper            __Radio               __Camp Fair     __Friend                __Store Flyer
 __Extension Office          __4-H Club           __Internet            __OTHER______________________
Summer Camp Information
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Updated: June 2007