AMC Reservation Form for Camps & Campgrounds
Name of Camp
: ________________________________
For period of (please give your choices):
1st:
______________________
to
______________________
2nd:
______________________
to
______________________
3rd:
______________________
to
______________________
Preferred location at camp (if applicable):
1st:
________________________________
2nd:
________________________________
3rd:
________________________________
Names
(Please attach separate sheet
with additional names.)
AMC Membership
(Number and type
if applicable.)
Age
(if under 21
as of July 1.)
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
4. _____________________________________________________________
5. _____________________________________________________________
6. _____________________________________________________________
Address
___________________________________________________________
City
_______________________
State
_________________
Zip
________
Home Phone
__________________
Work Phone
__________________
Email ______
________________________
License Plate no.
_________________
Registration Fee Enclosed
$_________________
MC/Visa _______________________
Exp. date _____________
(Not accepted at all facilities; check camp descriptions,
www.outdoors.org/lodging/camps/
)
Self-addressed stamped envelope enclosed?
Yes
______
No
______
Can you provide transportation for someone else in your area?
Yes
______
No
______
Do you need transportation?
Yes
______
No
______
Launch time desired (Three Mile Island only)
___________________
Signature:
____________________________________
Date:
____________________________________