Reg. Form: Peace Camp, canceled due to lack of grant funds
Please send this form with a $25 non-refundable deposit per  child.  Make the check payable to Peace Camp. Send it to: Peace Camp, P.O. Box 448, Lakeport, CA 95453. We go by the postmark to determine priority. Balance is due two weeks before camp begins.   Scholarships no longer available.
Questions?  Email Mary, our director, at marymiche[at] or call (510) 845-8417 to leave a message.

Child’s Name _______________________________________Age (when camp starts)____Session______

Parents’ Names _________________________________________________________________________

Phone Numbers (H) ____________________(W)_____________________ (Extra)___________________

Address of child ________________________________________________________________________

      City _________________________________________________ Zip Code _______________

Parent Signature __________________________________________________________ Date__________

parent email_____________________________________________________________________________

How did you hear about us?_______________________________________________________________

Click below to return to Peace Camp Website
We do not give out scholarships because we have lowered the price for everyone. Everybody gets a scholarship.