Author: Kara McClure

Camp Love-A-Pet 2021 Application
$300 per child; ages 10 — 15
Please Check one: OR
Today’s Date:_________
Camper’s Name:________________________________________________________________Age _____________
Address:_______________________________________________City_____________________Zip_____________
Parent’s Name:__________________________________________________________________________________
Email Address:__________________________________________________________________________________
Address: (If different from above)_________________________________________________________________________
Phone Numbers: (Home) _____________________________________(Cell)___________________________________
T-shirt size - Child Size: S ______M ______L______ Adult Size: S______M ______L______ XL _____XXL______
Medications: (If any)_______________________________________________________________________________
Allergies: (If any)__________________________________________________________________________________
Emergency Contact:_____________________________________________(Phone)___________________________
Camper ONLY
Have you been to Camp Love-A-Pet before, and if so, when? _______________________________________________________________
Please submit an essay of at least 200 words explaining your reason for wanting to attend Camp Love A Pet.
Have you worked with animals before?__________________________________________________________________________________
What do you hope to learn at Camp Love A Pet?_________________________________________________________________________
__________________________________________________________________________________________________________________

June 12-26
Orientation: June 12
Graduation: June 26

July 24 -August 7
Orientation: July 24
Graduation: August 7

Parent ONLY
Please initial below
_____________________ I hereby give permission for my child to attend field trips.
I hereby authorize Haven Humane Society to use my child’s image in any media for promotional reasons.
_____________________ I hereby give permission for my child to handle dogs and/or cats.
_____________________ I hereby acknowledge that my child is REQUIRED to attend both Orientation and Graduation.
______________________________________________Parent/Guardian Signature

A minimum deposit of $150 is required at the time of registration.
The balance due for all registrations is May 1.
A full refund (less a $10 handling and processing fee) will be issued if requested by March 31. A 75% refund will be issued after March 31. No refunds will be issued after April 30 unless the opening is filled by another camper. There will be a limited amount of scholarships available. Parents who are applying for a scholarship based on financial need must deposit $50 at the time of registration.
q I will be applying for a scholarship based on financial need. Scholarship assistance can be in the amount of $25 to $150. I have included my Camp Application, Scholarship Application, a $50 deposit.

P.O. Box 992202
Redding, CA 96099-2202
(530) 241-1653
(530) 605-3515 FAX