April 6-10, 2009 Camp will run from 9 am – 4 pm.

Cost: $50/week (Scholarships available – please call for information)

With extended hours from 8 am – 9 am and 4 pm – 5 pm

Cost for extended hours $5/hour plus $10 late fee after 5pm

BRING YOUR OWN LUNCH Healthy Snack provided

Felts Audubon Preserve in Palmetto (corner of 24th Ave. East & Experimental Farm Rd.)

Call Karen Fraley (941) 794-8773 phone/fax or (941) 704-4325 field phone

Checks payable to: Around the Bend Nature Tours

                    1815 Palma Sola Boulevard, Bradenton, FL 34209

Please complete in Black Ink Return this portion for registration

Camper’s name________________________________ Registration date__________

Camper’s birthdate ________________ Age _________ Amount Paid _____________

Mother’s Name ______________________ Father’s Name ______________________

Street Address ____________________________City ________________Zip _______

Home Phone __________________ Pager _______________ Cell ________________

Mother’s Place of Employment ___________________________Phone_____________

Street Address ____________________________City ________________Zip _______

Father’s Place of Employment ___________________________Phone_____________

Street Address ____________________________City ________________Zip _______

Alternative Emergency Contacts

Name_____________________________Relation______________Phone__________

Name_____________________________Relation______________Phone__________

Camper’s Allergies (include insect bites) _______________________________________

In an emergency requiring medical attention, I authorize the representative of Around the Bend Nature Tours to
obtain and give consent to the administration for whatever medical treatment is deemed necessary.
I do hereby release Around the Bend Nature Tours from any and all claims that may arise from said
representatives obtaining and consenting to medical treatment. I also authorize minor first aid as needed for my child.

Parent Signature_________________________________________Date___________