Families with Children from China Northwest (FCC-NW)
2014 Chinese American Heritage Camp Registration Form
Fort Casey on Whidbey Island •July 10, 11 & 12, 2015
Sign up today to secure your spot at the FCC-NW 2015 Chinese American Heritage Camp!
Regular registration: postmarked May 26 to June 24 • Late registration: postmarked on June 25th or beyond
Mail the registration and waiver forms with the total payment to:
Colene Baker, 1511 S. 250th St., Des Moines, WA 98198
1. Please list the names of your family registering for camp (one registration form per family):
Names of Adults (18 and older)
2.
1.
3.
Names of Child(ren) (First and Last)
Age
Province
T-Shirt size
1.
2.
3.
4.
T-shirt sizing can be found at: http://www.fcc-nw.memberlodge.com/Resources/Documents/T-Shirt_sizes.doc
2. Contact Information:
Parent(s) name:__________________________________________________________________________
Parent(s) address: _______________________________________________________________________
City, State, Zip: _________________________________________________________________________
Cell Phone: _____________________ Email: ________________________________________________
3. Indicate any special needs for your family. (i.e., Canadian floor, Single Mother floor, Dad’s floor, near
specific families or Staff Quarters. Staff Quarters are prioritized for special needs families and camp
coordinators).
Please let us know of any special needs or special requests (near another
 Canadian floor
family, wheelchair accessibility), etc.
 Single Mother floor
 Dad’s floor
 Vegetarian Meals
# of people _______
Heritage Camp 2015 Fees
Note: Camp Casey changed their age groupings for food and lodging costs; however, costs are similar to last year.
Cost if
postmarked
before May
26
Cost if
postmarked and
paid between May
9 and June 24
Cost if
postmarked
and paid after
June 24
Adults (ages 18+)
$120
$130
$140
Youth (10 – 17 yrs)
$115
$125
$130
Children (5 – 9 yrs)
$95
$105
$115
Infants (0-4 yrs)
Free
Free
Free
Option 2: Off-campus lodging
(includes day use fees / 5 meals)
Adults (ages 18+)
$75
$85
$95
Youth (10 – 17 yrs)
$70
$75
$85
Children (5 – 9 yrs)
$50
$55
$60
Infants (0-4 yrs)
Free
Free
Free
Option 3: Saturday Only (includes
day use fees / Saturday lunch and
salmon dinner)
Adults (ages 18+)
$55
$65
$75
Youth (10 – 17 yrs)
$55
$60
$70
Children (5 – 9 yrs)
$40
$50
$60
Infants (0-4 yrs)
Free
Free
Free
Adults, Youth & Children
$25
$35
$45
Infants (4 yrs and under)
Free
Free
Free
Option 1: On-campus lodging
(includes day use fees/
2 nights / 5 meals)
Number
of
people
Total
Free
Free
Free
Option 4: Attending Camp, with own
housing and meals
Camp shirts (Each child gets one shirt free)
# of
shirts
Indicate child or
adult and size(s)
Adults (same sizes for men and women –
see website for sizes) XS, S,M,L,XL,2X,3X
Important information:




Registration will not be complete
until all fees are paid.
Information packets for camp will be
emailed two weeks before camp.
Make checks payable to FCC-NW.
Mail your total payment (in U.S. dollars),
Waiver form, and Registration Form to:
Colene Baker,
1511 S. 250th St.
Des Moines, WA 98198
*We cannot guarantee there will be enough supplies
for families who register after June 24th.
x $10
Free
total
$10 each
Total for Options 1, 2, 3 and 4
Family Activity Fee
(applies to all families -- non-refundable)
$ 50
Non FCC-NW member fee
(The fee will be applied to membership)
$ 25
Total: Make checks payable to FCC-NW
Housing Preference – write preference on back.
Staff quarters are priority for camp organizers and special needs
families. Please indicate special requests/families (i.e., single
mother dorm, Dad dorm, Canadian dorm, staff quarters, etc.)