Reg. Form: Santa Rosa Peace Camp Aug 3-7, 2021  cost $99.
 You may send this form with $99. per child to Peace Camp, PO Box 448, Lakeport, CA 95453.
 Make the check payable to Peace Camp   We go by the postmark to determine priority. 
Questions?  Email Mary, our director, or leave a message on her phone (510) 845-8417

Child’s Name _________________________________________________Age (when camp starts)______

Parents’ Names _________________________________________________________________________

Phone Numbers cell____________________home_____________________ work___________________

Address of child ________________________________________________________________________

      City _________________________________________________ Zip Code _______________

Parent Signature __________________________________________________________ Date__________

parent email_____________________________________________________________________________

How did you hear about us?_______________________________________________________________


Click on link below to return to Peace Camp Website
We do not offer scholarships because we offer a low price for everyone rather than giving scholarships to a few children.
Click on the button above to fill out an online registration. 
Please send a check to hold your spot at Peace Camp.
Make the check payable to Peace Camp and send it to PO box 448, Lakeport, CA 95453.  
We do not hold a place open for unpaid registrations.   
Questions? Email Mary, our director, or leave a message on her phone (510) 845-8417
Sorry, we are now full for 2016, check back next year
    We offer just one week, Aug 3-7, 2021
​    Registration for 2021 opens in March
We will be taking only 20 children for the week.