Please print this form and fill out.

Name:                                                          

Address:                                                     

                                                                  

email:                                                          

Phone:                                                        

I would like to share a cabin with:

                                                  

Gender:    

  • male     
  • female

I would like to rent:

  • a canoe

I would like to help with:

  • camp registration
  • music
  • group games
  • cooking
I would like to register for Lua Viet 20 Years Anniversary Camp. Enclosed is a check for $85 for my camp registration (postdated by 9/30/2002, otherwise $100 by 10/10/2002, or $125 on site)


Please send the completed form with your check to :

Lua Viet Camp 2002
P.O. Box 349
Marlboro, NJ  07746-0349
Your confirmation and directions to camp will be sent to your email address if available;  otherwise, they will be sent to your home address

Deadline is September 30th

Full refund if cancelled by September 30th
luaviet@luaviet.org 08/27/02 22:35