White Water Institute Summer 2010 Registration Form

Selections in bold must be completed.

Name:

Address:

City:

State:

Zip:

Telephone:

Email:

Session:

Registration Deadline for the first session is June 13, 2010 - Cost: $865
Registration Deadline for the second session is July 11, 2010 - Cost: $865
Registration Deadline for the August session is July 28, 2010 - Cost: $865
Registration Deadline for the September session is August 24, 2010 - Cost: TBD

Please check all that apply

 I will camp and have my own equipment.
 I will camp but need to rent a tent (Tent rental $10.00). Note: You need to bring your own sleeping bag.
 I will come in a RV and will need a hookup. (Add an additional $28/night.)
 I will stay at the nearby Imperial Lodge. (You are responsible for booking your own room.)
 I will sign up for university credit (Additional fee).
 I have mailed a down payment of $300 to reserve my place. (Remainder of $535 due by June 30, 2009.)
 I have mailed the entire registration fee of $865.

Refunds will be provided for cancellations received in writing or via email 30 days in advance of session. A $100 cancellation fee will be deducted. No refunds will be made on any cancellation after the 30 day advance deadline.

We are happy to accommodate any special dietary or physical needs. Please describe in the box below:

Make check out to "White Water Institute" and send down payment or full payment to:

Marilyn Lane
PO Box 2837
Gearhart, OR 97138