The moon rises over Hope Island

 Please submit the following information by:
May 31, 2001
for the June 10 - 15 adventure
June 7, 2001
for the June 17 - 22 adventure
June 14, 2001
for the June 24 - 29 adventure
       _________________
August 30, 2001
for the September 9 - 14 adventure
September 6, 2001
for the September 16 - 21 adventure
September 13, 2001
for the September 23 - 28 adventure
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Please provide the following contact information:

First Name required field
Last Name required field
Street Address required field
Address (cont.)
City required field
State/Province required field
Zip/Postal Code required field
Country
Work Phone
Home Phone required field
E-mail required field

Please indicate the session you wish to attend: 

Please provide the following information:

QTY DESCRIPTION
Females
Males

 

TOTAL
@ $1,310 each 
+ optional $250 for single occupancy

Deposit of $500 per person is required before the registration deadline.  Please make checks payable to Chebeague Recreation Center.

BILLING
  NOTE:  This is not a secure site!  If you would rather provide your credit card number over the telephone, please submit this form and we will call you back within 24 hours.

 

Credit card information included in form

Please call me at home for credit card info

Please call me at work for credit card info

 
Total to be charged to credit card
Credit Card
Cardholder Name
Card Number
Expiration Date

 

Please click here to send e-mail to:

trailblazer@MaineIslandAdventure.org

© Chebeague Recreation Center, 2001
382 North Road, Box 320
Chebeague Island, Maine 04017

Call 207.846.5068 or toll-free: 1.888.905.9700

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